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Abstract ID: 24-113

Preoparative planning for Dacryocystorhinostomy (DCR) surgery by Virtual Reality

Ayelet Priel


To assess a novel Virtual Reality (VR) tool designed to enhance understanding of the nasal anatomy, and planning surgery in patients eligible for DCR (Dacryocystorhinostomy).


Preoperative CT scans of the orbit were obtained and loaded as DICOM (Digital Imaging and Communications in Medicine) files onto the D2P software (3D Systems Inc., Littleton, CO) for tissue segmentation and 3D model preparation. Segmentation was performed on several anatomical structures, including the skull, lacrimal sac, nasal septum, inferior and middle turbinate. The resulting 3D model was visualized using a VR headset. After completing the segmentation procedure, ten cases were evaluated by a panel of six surgeons, including both senior and resident physicians from ENT and oculoplastic specialties.


The dataset under examination comprised images from 10 preoperative CT scans of the orbits of patients eligible for Endo-DCR. When evaluating the CT using the VR tool, in 73.3% of the cases ENT surgeons were right about the side of pathology while only 43.3% ophthalmologists were right (chi square, p=0.018). In 72.8% of the cases ENT surgeons were evaluated right that there is a septum deviation while only in 47.2% of the cases the ophthalmologists were right (chi square, p=0.094).
When evaluating the CT using the VR tool, in 60% of the cases consultants were right about the pathology while 57.7% of the residents were right (chi square, p=0.853). In 81.7% of the cases consultants were evaluated right that there is a septum deviation while only in 58.3% of the cases he ophthalmologists were right (chi square, p=0.198).


to the best of our knowledge, this is the first time that VR is used as an assistant tool in preparing for DCR surgery. in this study we found that the VR tool has an advantage in understanding the nasal anatomy, especially for residents and ophthalmologists.

Additional Authors

Ofira Zloto – Sheba Medical Center

Dor Hadida – Sheba Medical Center

Shay Tejman-Yarden – Sheba Medical Center

Oliana Vazhgovsky – Sheba Medical Center

Arkadi Yakirevich – Sheba Medical Center

Gabriel Nakash – Sheba Medical Center

noa Kapoloshnick – Sheba Medical Center

Gal Cohen – Sheba Medical Center

Oded Sagiv – Sheba Medical Center

Hadas Knoler – Sheba Medical Center

Shaked Shivatzki – Sheba Medical Center