Surgical assistance for instruments' power control based on navigation and neuromonitoring

Area of Science:

• Neurosurgery
• Medical Instrumentation
• Biomedical Engineering

Background:

• Nerve injuries are a risk in ear, nose, throat (ENT), and skull base surgery.
• Navigated Control Functional (NCF) uses navigation and neurophysiologic monitoring to control instrument power.
• Electrical stimulation is typically needed to interpret neurophysiologic signals for distance estimation.

Purpose of the Study:

• To investigate the relationship between Electromyography (EMG) signals and nerve-instrument distance without electrical stimulation.
• To assess the feasibility of using intraoperative EMG signals for nerve proximity monitoring.
• To evaluate the correlation between EMG and nerve-instrument distance in ear surgery.

Main Methods:

• Intraoperative recording of EMG signals and position data during ear surgery.
• Statistical analysis using Spearman's rank correlation coefficient.
• Evaluation of correlation based on varying time ranges, thresholds, and windows.

Main Results:

• Occasional positive correlations between EMG signals and nerve-instrument distance were observed.
• These correlations reached statistical significance at the 5% level.
• The observed positive correlations contrasted with the expected negative correlation.

Conclusions:

• A potential relationship exists between EMG signals and nerve-instrument distance without external stimulation.
• The correlation's significance and nature are highly dependent on analysis parameters.
• Further research is needed to validate and refine this non-invasive monitoring approach for surgical safety.