Int J Comput Assist Radiol Surg - Warning navigation system using real-time safe region monitoring for otologic surgery.

Tópicos

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Resumo

RPOSE: 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.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.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.CONCLUSIONS: This system could assist surgeons in preserving the facial nerve and potentially contribute to enhanced patient safety in the surgery.

Resumo Limpo

rpose develop surgic navig system warn surgeon auditori visual feedback protect facial nerv realtim monitor safe region drillingmethod warn navig modul develop integr free open sourc softwar platform obtain high registr accuraci use highprecis lasersint templat patient bone surfac regist comput tomographi ct imag calcul closest distanc drill tip surfac facial nerv drill drill tip enter safe region navig system provid auditori visual signal differ safe region evalu effect system perform phantom experi maintain given safe margin facial nerv drill bone model without navig system error safe margin measur postop ct imag real surgeri evalu feasibl system comparison convent facial nerv monitoringresult navig accuraci submillimet target registr error phantom studi task navig formula see text mm success smaller error task without navig formula see text mm formula see text clinic feasibl system confirm three real surgeriesconclus system assist surgeon preserv facial nerv potenti contribut enhanc patient safeti surgeri

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