Immersive Neurosurgical Anatomy Using Photogrammetry: Technical Note and Scoping Review

Abstract

Introduction: Photogrammetry holds promise for expanding the domains of microsurgical education. The authors present a technical note and scoping review that explore the use of photogrammetry in neurosurgical anatomy, existing technical guidelines, and areas of implementation. Methods: Photogrammetry was employed to build three-dimensional models of the anatomy of the white matter tracts, brainstem, cranial nerves, and the retrosigmoid approach using human brain and skull specimens. In addition, a scoping review was performed on three databases (PubMed, Scopus, and Embase). Information was collected regarding human models, software, hardware, assessment of high-fidelity reconstruction, and anatomic depth estimation. Results: The illustrative models achieved a high-quality representation of the white matter tracts, brainstem, cranial nerves, and anatomy in the retrosigmoid approach. Our scoping review yielded 3,620 articles, of which 28 were included in the analysis. Photogrammetry was described in three technical stages: image acquisition, processing, and visualization. About 75% of studies reported high-fidelity image reconstruction, and only 42.9% of articles performed anatomic depth estimation. Concerning microsurgical anatomy education, photogrammetry has primarily rendered digital models of the cranial region (96.4%). During educational sessions, the most common surgical approaches described the orbitozygomatic (20%), endoscopic endonasal (20%), translabyrinthine (13.3%), retrosigmoid (13.3%), and Kawase (13.3%) approaches. Conclusion: Photogrammetry offers an innovative approach to creating portable and virtual anatomical models with high-fidelity and vivid representations of human specimens. The resulting three-dimensional models can provide real proportions to teach visuospatial skills in neurosurgery. However, significant challenges remain to achieve objective accuracy and anatomic depth perception, which are critical for microsurgical education.