Morphometric Alterations of the Sphenoid Ostium and other Landmarks in Acromegaly: Anatomical Considerations and Implications in Endoscopic Pituitary Surgery

Surgical Navigation in the Anterior Skull Base Using 3-Dimensional Endoscopy and Surface Reconstruction

“…This challenge has led to widespread interest in training models to help develop this ability before a trainee first operates on a live patient. 6 However, many of these models have been limited due to inadequate simulation of haptic feedback, inaccurate anatomical prototypes, and high cost. Nevertheless, surgical navigation with augmented reality may be a valuable tool in this arena, allowing trainees to participate in live surgery with enhanced ability for supervising physicians to delineate critical nearby structures and more accurately describe deeper danger zones in the case.…”

“…Endoscopic endonasal surgery (EES) is the predominant approach for operative management of sinonasal and anterior skull base disorders, and more than a quarter million endoscopic sinus surgeries are performed per year in the US . EES surgeons must use tactile feedback from their surgical instruments and sustain a high level of focus to maintain anatomic orientation given substantial interpatient variability in anatomy . Failure to maintain anatomic orientation can be associated with injury to intracranial, vascular, and orbital structures with substantial patient morbidity …”

“…[1][2][3] EES surgeons must use tactile feedback from their surgical instruments 4 and sustain a high level of focus to maintain anatomic orientation given substantial interpatient variability in anatomy. [5][6][7] Failure to maintain anatomic orientation can be associated with injury to intracranial, vascular, and orbital structures with substantial patient morbidity. [8][9][10] Image guidance is used by most sinus and skull base surgeons.…”