Accuracy and feasibility of a dedicated image guidance solution for endoscopic lateral skull base surgery.

Rathgeb, Christoph Martin; Anschütz, Lukas Peter; Schneider, Daniel; Dür, Cilgia; Caversaccio, Marco; Weber, Stefan; Williamson, Tom (2018). Accuracy and feasibility of a dedicated image guidance solution for endoscopic lateral skull base surgery. European archives of oto-rhino-laryngology, 275(4), pp. 905-911. Springer 10.1007/s00405-018-4906-7

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OBJECTIVE We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. MATERIALS AND METHODS The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table. Active optical tracking references are rigidly fixed to both the patient and surgical tools. Software to support image import, registration and 2D/3D visualization has been developed. Two models were used for targeting accuracy assessment: a technical phantom model and an ex vivo temporal bone model. Additionally, workflow integration and usability of the navigation system during endoscopic lateral skull base procedures was investigated in ex vivo experiments on 12 sides of cadaver head specimens. RESULTS The accuracy experiments revealed a target registration error in the technical phantom model of 0.20 ± 0.10 mm (n = 36) and during the ex vivo assessment of 0.28 ± 0.10 mm (n = 21). Navigation was successfully carried out in n = 36 procedures (infracochlear, suprageniculate and transpromontorial approach), with navigated instruments usable without interference with the endoscope. The system aided in the successful and accurate identification of vital anatomical structures. CONCLUSIONS Useful surgical navigation is, to a large extent, a result of sufficiently accurate tracking technology. We have demonstrated sufficient accuracy and a potentially suitable integration for surgical application within endoscopic lateral skull base procedures.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Rathgeb, Christoph Martin; Anschütz, Lukas Peter; Schneider, Daniel; Dür, Cilgia; Caversaccio, Marco; Weber, Stefan and Williamson, Tom

Subjects:

600 Technology > 610 Medicine & health
600 Technology > 620 Engineering

ISSN:

0937-4477

Publisher:

Springer

Language:

English

Submitter:

Wilhelm Wimmer

Date Deposited:

19 Apr 2018 15:56

Last Modified:

25 Apr 2018 13:34

Publisher DOI:

10.1007/s00405-018-4906-7

PubMed ID:

29442163

Additional Information:

Christoph Rathgeb and Lukas Anschuetz contributed equally to this work.

Uncontrolled Keywords:

Endoscopic ear surgery Endoscopic lateral skull base surgery Image-guided therapy Lateral skull base Navigation

BORIS DOI:

10.7892/boris.111786

URI:

https://boris.unibe.ch/id/eprint/111786

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