Use of Augmented Reality Navigation in Pediatric Deep Cerebellar Tumor Resection: An Illustrative Case

Background Pediatric central nervous system tumors, such as medulloblastomas, are rare but represent the second most common childhood malignancy. Despite advancements in technology, resecting deep-seated tumors within the posterior fossa remains challenging due to critical surrounding structures, such as the straight sinus, and potential complications, including neurological deficits and posterior fossa syndrome. Augmented reality (AR) technology has emerged as a promising tool, providing real-time visualization of critical anatomy to enhance precision and safety during surgery. This case represents the first reported application of AR-assisted navigation for the resection of a pediatric deep cerebellar tumor. Observations We present the case of a 14-year-old female with recurrent medulloblastoma who underwent surgical resection aided by AR navigation. The AR technology was a hands-free headset (Microsoft HoloLens) with integrated navigation software (Xironetics) which allowed surgeons to overlay critical anatomy while orienting themselves in 3D space. The tumor was successfully resected without complications, and AR navigation demonstrated significant utility in preoperative planning, incision guidance, and real-time depth perception. Lessons This case highlights the potential of AR navigation to improve patient safety, enhance surgical accuracy, and optimize outcomes in complex neurosurgical cases. The use of AR-navigation technology offered distinct advantages, such as accurate cranial surface mapping, hands-free navigation, and real-time deep anatomical visualization. Our report highlights a new generation of AR technologies with positive outcomes, which motivates the need for further research, including prospective, multi-center studies, to validate the broader application of AR in neurosurgery.