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Template-based registration for image-guided skull base surgery.

Georg Eggers1, Joachim Mühling

  • 1Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany. georg.eggers@med.uni-heidelberg.de

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 6, 2007
PubMed
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Maxillary template registration is accurate for anterior skull base surgery but not the lateral skull base. This fiducial marker method offers a noninvasive approach for image-guided frontal skull base procedures.

Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Surgical Navigation

Background:

  • Image-guided surgery enhances surgical precision.
  • Accurate patient-to-image registration is crucial for minimally invasive skull base procedures.
  • Maxillary templates offer a potential noninvasive registration method.

Purpose of the Study:

  • To assess the accuracy of patient-to-image registration using a maxillary template for image-guided skull base surgery.
  • To determine the suitability of this method for anterior versus lateral skull base approaches.

Main Methods:

  • An experimental phantom study was conducted.
  • Pair-point registration of a skull phantom to CT data was performed using 243 maxillary template configurations.
  • Infrared tracking determined the location of artificial skull-mounted markers.

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Main Results:

  • Average target registration error was 1.57 mm in the anterior skull base.
  • Average target registration error was 3.31 mm in the lateral skull base.
  • Accuracy varied significantly between anterior and lateral regions.

Conclusions:

  • Fiducial marker registration with a maxillary template is accurate for the anterior skull base.
  • This method is not sufficiently accurate for the lateral skull base.
  • Template-based registration presents an accurate, noninvasive option for frontal skull base surgery.