Abstract:
Precise recognition of the intraparotid facial nerve (IFN) is crucial during parotid tumor resection. We aimed to explore the application effect of direct visualization of the IFN in parotid tumor resection. Fifteen patients with parotid tumors were enrolled in this study and underwent specific radiological scanning in which the IFNs were displayed as high-intensity images. After image segmentation, IFN could be preoperatively directly visualized. Mixed reality combined with surgical navigation were applied to intraoperatively directly visualize the segmentation results as real-time three-dimensional holograms, guiding the surgeons in IFN dissection and tumor resection. Radiological visibility of the IFN, accuracy of image segmentation and postoperative facial nerve function were analyzed. The trunks of IFN were directly visible in radiological images for all patients. Of 37 landmark points on the IFN, 36 were accurately segmented. Four patients were classified as House-Brackmann Grade I postoperatively. Two patients with malignancies had postoperative long-standing facial paralysis. Direct visualization of IFN was a feasible novel method with high accuracy that could assist in recognition of IFN and therefore potentially improve the treatment outcome of parotid tumor resection.
摘要:
在腮腺肿瘤切除术中,精确识别腮腺内面神经(IFN)至关重要。目的探讨直接可视化IFN在腮腺肿瘤切除术中的应用效果。本研究招募了15例腮腺肿瘤患者,并进行了特定的放射学扫描,其中IFNs显示为高强度图像。图像分割后,IFN可以在术前直接可视化。将混合现实与手术导航相结合,在术中直接将分割结果可视化为实时三维全息图,指导外科医生进行IFN解剖和肿瘤切除。IFN的放射学可见性,对图像分割的准确性和术后面神经功能进行分析。在所有患者的放射学图像中都可以直接看到IFN的树干。在IFN的37个里程碑中,36个被准确分割。术后有4例患者被归类为House-BrackmannI级。两名恶性肿瘤患者术后长期面瘫。IFN的直接可视化是一种可行的新方法,具有很高的准确性,可以帮助识别IFN,因此有可能改善腮腺肿瘤切除术的治疗结果。