Intraoperative Subcortical Electrical Mapping of the Optic Tract in Awake Surgery Using a Virtual Reality Headset

Mazerand, Edouard; Renard, Marc Le; Hüe, Sophie; Lemée, Jean‐Michel; Klinger, Évelyne; Menei, Philippe

doi:10.1016/j.wneu.2016.10.031

Cited by 37 publications

(43 citation statements)

References 20 publications

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“…We have developed several different approaches using different types of headsets and software. The first virtual reality (VR) tasks were developed with the aim of preventing postoperative hemianopsia and unilateral neglect [4]. However, the risk of VR sickness or VRH-induced seizures raised concerns for all screen-based video games [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Casanova¹,

Clavreul²,

Soulard³

et al. 2021

J Med Internet Res

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Background Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. Objective This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. Methods We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. Results None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. Conclusions We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. Trial Registration ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

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Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Casanova¹,

Clavreul²,

Soulard³

et al. 2021

J Med Internet Res

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“…The formation of the ampulla-shaped cavity and the unidirectional flap -'Maximum safe resection' and 'minimally invasive' as the widely accepted concept in recent years in the field of surgical treatment of glioma [8]. With the application of multiple assistive technologies (virtual reality technology, intraoperative navigation, intraoperative MRI, intraoperative fluorescence guide resection, conscious sedation for glioma resection), the rates of gross total resection (GTR) have been greatly increased, and the protection of brain parenchyma around glioma tissue is also getting better and better [9][10][11][12][13]. However, with the above progress, especially the continuous enlargement of the extent of glioma resection, the volume of residual cavity after resection of the glioma increases continuously.…”

Section: Discussion I the Causes Of Tensile Effusion In The Postoperamentioning

confidence: 99%

Surgical Treatment of Tensile Effusion in Postoperative Cavity after Glioma Resection

Huang¹,

Yang²,

Lv³

et al. 2020

SCR

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Objectives: To explore the clinical surgical methods for the treatment of tensile effusion in postoperative cavity after glioma resection. Methods: Clinical data of 26 cases of tensile effusion in postoperative cavity after glioma resection were analyzed retrospectively. All 26 patients underwent surgical treatment, including 16 cases who underwent puncture and drainage (P&D), and 10 cases who underwent craniotomy decompression (CD). Among the cases of P&D, postoperative cavity in 7 cases were punctured through the burr hole for creating the skull flap for intraoperative resection of glioma, and postoperative cavities in 9 cases were punctured through a burr hole for the dura mater suspended under the skull flap. Glasgow Coma Scale (GCS) was used to evaluate the consciousness status of the two groups of patients before and after surgery. Moreover, time of operation, intraoperative blood loss, postoperative hospital duration, and postoperative complications were also adopted for evaluation of the merits of the two methods for treatment of tensile effusion in postoperative cavity after glioma resection. Results: The consciousness of the patients in both groups improved within 24 hours after the operation, and there were no death cases. In the P&D group, the GCS score within 24 hours after surgery was (14.38±0.20), the time of operation time was (7.81±0.64) mins, intraoperative blood loss was (6.25±0.56) ml, and postoperative hospital duration was (6.69±0.54) days. There were 3 cases with postoperative complications (1 case of puncture tract hemorrhage, 1 case of subdural hematoma and 1 case of intracranial infection) in the P&D group. All of the puncture tract hemorrhage and subdural hematoma did not require surgical treatment, and the intracranial infection was cured after antibiotic treatment and lumbar puncture for cerebrospinal fluid replacement. In the CD group, the GCS score within 24 hours after surgery was (13.70±0.21), the time of operation was (124.10±8.96) mins, intraoperative blood loss was (260±30.55) ml, and postoperative hospital duration was (11.30±0.60) days. There were 2 cases with postoperative complications (both of them were with subdural hematoma), none of which required surgical treatment. The GCS score, time of operation, intraoperative blood loss and postoperative hospital duration in the P&D group were better than those in the CD group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P >0.05). Conclusion: The P&D and CD for tensile effusion in postoperative cavity after glioma resection can both achieve ideal results, but P&D in line with the concept of micro-invasive neurosurgery was better than CD in terms of postoperative GCS score within 24 hours, duration of operative, intraoperative blood loss, and postoperative hospital duration.

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“…They reported that all the 14 patients experienced visual symptoms during awake surgery; thus, optic radiations were identified and protected with only one patient having permanent postoperative hemianopia. Recently, an integrated method of visual pathway tracking using both diffusion tensor imaging and DES was reported, indicating the potential advantages of multimodal brain mapping (Mazerand et al, 2017).…”

Section: Visionmentioning

confidence: 99%

Intraoperative Cognitive Mapping Tasks for Direct Electrical Stimulation in Clinical and Neuroscientific Contexts

Zhang

et al. 2021

Front. Hum. Neurosci.

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Direct electrical stimulation (DES) has been widely applied in both guidance of lesion resection and scientific research; however, the design and selection of intraoperative cognitive mapping tasks have not been updated in a very long time. We introduce updated mapping tasks for language and non-language functions and provide recommendations for optimal design and selection of intraoperative mapping tasks. In addition, with DES becoming more critical in current neuroscientific research, a task design that has not been widely used in DES yet (subtraction and conjunction paradigms) was introduced for more delicate mapping of brain functions especially for research purposes. We also illustrate the importance of designing a common task series for DES and other non-invasive mapping techniques. This review gives practical updated guidelines for advanced application of DES in clinical and neuroscientific research.

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Intraoperative Subcortical Electrical Mapping of the Optic Tract in Awake Surgery Using a Virtual Reality Headset

Cited by 37 publications

References 20 publications

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

Surgical Treatment of Tensile Effusion in Postoperative Cavity after Glioma Resection

Intraoperative Cognitive Mapping Tasks for Direct Electrical Stimulation in Clinical and Neuroscientific Contexts

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