• Giselle Coelho, Eduardo Varjão Vieira, Nicollas Nunes Rabelo, Thailane Marie, Daniella Brito, Emilio C Del Massa, Kid Mendes, Gustavo Zagatto, Ana Carolina Maschietto, Rian Peixoto, Júlio Sérgio de Souza, Zacharias Calil, and Mauricio Yoshida.
• Division of Neurosurgery, Santa Marcelina Hospital, São Paulo, São Paulo, Brazil; Scientific Board, EDUCSIM Institute, São Paulo, São Paulo, Brazil; Division of Neurosurgery, São Paulo University, USP, São Paulo, São Paulo, Brazil; Division of Craniofacial Surgery, Sabará Children's Hospital, São Paulo, São Paulo, Brazil. Electronic address: gigicoelho7@hotmail.com.
• World Neurosurg. 2021 Jul 1; 151: 124-131.

ObjectiveLate surgical correction of meningoencephalocele is a rare scenario that remains challenging for surgeons. Three-dimensional models can mimic the correct anatomical relationships, and technological systems have brought advances to medicine. This study aims to present a novel preoperative planning modality that combines augmented reality with a hybrid model for complex malformation associated with late correction.MethodsThe present report describes a case of frontoethmoidal encephalocele of a 10-year-old girl. Two different methods for planning the approach were developed: 1) a hybrid hands-on model and 2) augmented reality, using a cell phone app and headset display. The customized hybrid model was created based on patient's imaging. The augmented reality app was developed with a real-time interface.ResultsThe hybrid model recreated anatomic alterations, thereby allowing a multidisciplinary team to determine an appropriate surgical approach. All aspects of the surgical procedure were simulated. A pre- to postoperative comparison was made, which emphasized benefit of tridimensional anatomical relationships using augmented reality tool and its role in preoperative planning.ConclusionsThe authors believe this new multimodality preoperative platform could be a useful method to improve multidisciplinary discussion as well as a powerful tool for teaching and planning.Copyright © 2021. Published by Elsevier Inc.

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