Augmented-reality-guided microvascular decompression for trigeminal neuralgia

Augmented reality (AR) allows surgeons to visualize three-dimensional (3D) patient anatomy overlaid onto the surgical field. Procedures such as microvascular decompression, which can be performed without neuronavigation, can benefit from the size, speed, and unique 3D visualizations of this technology. A 78-year-old male presented to neurosurgery clinic with 3 weeks of severe lancinating pain radiating into the right side of his face and jaw. Fast imaging employing steady-state acquisition sequencing showed a dolichoectatic, high-riding, and eccentric right vertebral artery compressing the inferior trigeminal nerve. The decision was made to take the patient for microvascular decompression of the trigeminal nerve. Hoth Intelligence's AR system was used for preoperative and intraoperative visualization of registered 3D cranial anatomy. This case describes the clinical utility of an AR system for surgical localization and intraoperative visualization during a microvascular decompression surgery. This technology is a feasible alternative to traditional neuronavigation for planning head position, surgical approach, and craniotomy location.