Distance Control and Virtual Drilling Improves Anatomical Orientation During Anterior Petrosectomy.

Background: A combined drill distance control and virtual drilling image guidance feedback method was developed.

Objective: To investigate whether first-time usage of the proposed method, during anterior petrosectomy (AP), improves surgical orientation and surgical performance. The accuracy of virtual drilling and the clinical practicability of the method were also investigated.

Implications of Extracranial Distortion in Ultra-High-Field Magnetic Resonance Imaging for Image-Guided Cranial Neurosurgery.

Background: Ultra-high-field magnetic resonance imaging (MRI) of the brain is attractive for image guidance during neurosurgery because of its high tissue contrast and detailed vessel visualization. However, high-field MRI is prone to distortion artifacts, which may compromise image guidance. Here we investigate intra- and extracranial distortions in 7-T MRI scans.

Simulating Internal Carotid Artery Injury during Transsphenoidal Transclival Endoscopic Surgery in a Perfused Cadaver Model.

 Managing internal carotid artery (ICA) injury during extended endoscopic transsphenoidal surgery is an extreme challenge. We aimed to find a possible surgical treatment strategy.  We operated seven fresh, perfused cadaver heads with a transsphenoidal endoscopic approach of the ICA using a three-dimensional-high definition (3D-HD) endoscope.

Benchmarking Distance Control and Virtual Drilling for Lateral Skull Base Surgery.

Background: Novel audiovisual feedback methods were developed to improve image guidance during skull base surgery by providing audiovisual warnings when the drill tip enters a protective perimeter set at a distance around anatomic structures ("distance control") and visualizing bone drilling ("virtual drilling").

Objective: To benchmark the drill damage risk reduction provided by distance control, to quantify the accuracy of virtual drilling, and to investigate whether the proposed feedback methods are clinically feasible.

Methods: In a simulated surgical scenario using human cadavers, 12 unexperienced users (medical students) drilled 12 mastoidectomies.

Functional and structural brain networks in epilepsy: what have we learned?

Brain functioning is increasingly seen as a complex interplay of dynamic neural systems that rely on the integrity of structural and functional networks. Recent studies that have investigated functional and structural networks in epilepsy have revealed specific disruptions in connectivity and network topology and, consequently, have led to a shift from "focus" to "networks" in modern epilepsy research. Disruptions in these networks may be associated with cognitive and behavioral impairments often seen in patients with chronic epilepsy.