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Warning navigation system using real-time safe region monitoring for otologic surgery.
- Source :
-
International journal of computer assisted radiology and surgery [Int J Comput Assist Radiol Surg] 2013 May; Vol. 8 (3), pp. 395-405. Date of Electronic Publication: 2012 Nov 16. - Publication Year :
- 2013
-
Abstract
- Purpose: We developed a surgical navigation system that warns the surgeon with auditory and visual feedback to protect the facial nerve with real-time monitoring of the safe region during drilling.<br />Methods: Warning navigation modules were developed and integrated into a free open source software platform. To obtain high registration accuracy, we used a high-precision laser-sintered template of the patient's bone surface to register the computed tomography (CT) images. We calculated the closest distance between the drill tip and the surface of the facial nerve during drilling. When the drill tip entered the safe regions, the navigation system provided an auditory and visual signal which differed in each safe region. To evaluate the effectiveness of the system, we performed phantom experiments for maintaining a given safe margin from the facial nerve when drilling bone models, with and without the navigation system. The error of the safe margin was measured on postoperative CT images. In real surgery, we evaluated the feasibility of the system in comparison with conventional facial nerve monitoring.<br />Results: The navigation accuracy was submillimeter for the target registration error. In the phantom study, the task with navigation ([Formula: see text] mm) was more successful with smaller error, than the task without navigation ([Formula: see text] mm, [Formula: see text]). The clinical feasibility of the system was confirmed in three real surgeries.<br />Conclusions: This system could assist surgeons in preserving the facial nerve and potentially contribute to enhanced patient safety in the surgery.
- Subjects :
- Acoustic Stimulation instrumentation
Facial Nerve Injuries etiology
Facial Nerve Injuries prevention & control
Feasibility Studies
Humans
Models, Biological
Otologic Surgical Procedures adverse effects
Phantoms, Imaging
Photic Stimulation instrumentation
Reproducibility of Results
Feedback, Sensory
Image Interpretation, Computer-Assisted instrumentation
Medical Errors prevention & control
Monitoring, Intraoperative instrumentation
Otologic Surgical Procedures instrumentation
Surgery, Computer-Assisted instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 1861-6429
- Volume :
- 8
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of computer assisted radiology and surgery
- Publication Type :
- Academic Journal
- Accession number :
- 23161169
- Full Text :
- https://doi.org/10.1007/s11548-012-0797-z