Abstract: Endoscopic transnasal optic nerve decompression surgery plays a crucial role in minimal invasive treatment of complex traumatic optic neuropathy. However, a major challenge faced during the procedure is the inability to visualize the optic nerve intraoperatively. To address this issue, an endoscopic image-based augmented reality surgical navigation system is developed in this study. The system aims to virtually fuse the optic nerve onto the endoscopic images, assisting surgeons in determining the optic nerve’s position and reducing surgical risks. First, a calibration algorithm based on a checkerboard grid of immobile points is proposed, building upon existing calibration methods. Additionally, to tackle accuracy issues associated with augmented reality technology, an optical navigation and visual fusion compensation algorithm is proposed to improve the intraoperative tracking accuracy. To evaluate the system’s performance, model experiments were meticulously designed and conducted. The results confirm the accuracy and stability of the proposed system, with an average tracking error of (0.99 ± 0.46) mm. This outcome demonstrates the effectiveness of the proposed algorithm in improving the augmented reality surgical navigation system’s accuracy. Furthermore, the system successfully displays hidden optic nerves and other deep tissues, thus showcasing the promising potential for future applications in orbital and maxillofacial surgery.

Key words: optic nerve decompression, endoscopy, augmented reality, surgical navigation regret value, perceived heterogeneity, psychological distance

摘要： 内镜下经鼻视神经管减压手术是治疗复杂外伤性视神经病变的重要手段，但是其存在术中视神经不可见的难题。因此，开发了一套基于内窥镜图像的增强现实手术导航系统，实现视神经在内窥镜图像上的虚实融合显示，辅助医生判断视神经位置，降低手术风险。在现有的标定方法上，提出基于棋盘格不动点的标定算法；针对增强现实技术存在的精度问题，提出光学导航与视觉融合补偿算法提升术中跟踪精度。设计并开展模型实验，验证系统的精度和稳定性。所提出的增强现实系统平均跟踪误差为（0.99±0.46）mm，表明所提出的算法能够有效提升增强现实手术导航系统的精度，能够准确地呈现隐蔽的视神经等深部组织，未来在眶颌外科手术中将具有良好的应用前景。

关键词: 视神经减压，内窥镜，增强现实，手术导航