Application accuracy of computed tomography-based, image-guided navigation of temporal bone

Area of Science:

• Neurosurgery
• Medical Imaging
• Surgical Navigation

Background:

• Frameless stereotactic techniques are crucial in neurosurgery but require rigorous evaluation.
• Navigational accuracy is paramount for complex surgical sites like the temporal bone, where precision is critical.
• Existing literature on image-guided navigation accuracy in temporal bone surgery is limited.

Purpose of the Study:

• To investigate the application accuracy of computed tomography-based, frameless, image-guided navigation.
• To evaluate the system's ability to identify bony structures within the temporal bone using a retrosigmoid approach.

Main Methods:

• Ten retrosigmoid approaches were simulated on five fresh cadaveric heads.
• Six titanium microscrews served as bone reference markers.
• High-resolution computed tomography scans and a Stryker navigation system were utilized.

Main Results:

• The system achieved a target registration error of 0.48 +/- 0.21 mm.
• Overall navigation accuracy was 0.91 +/- 0.28 mm, with 0.94 +/- 0.22 mm for internal temporal bone targets.
• Ninety-five percent of targets were reachable within 1.4 mm.

Conclusions:

• Frameless navigation, guided by high-resolution CT and bone markers, demonstrates accuracy comparable to frame-based stereotaxy for temporal bone surgery.
• While not error-free for submillimetric anatomic contouring, it offers a valuable roadmap for maximizing surgical safety.
• This technology enhances safe surgical approaches to the temporal bone.