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Navigation accuracy after automatic- and hybrid-surface registration in sinus and skull base surgery
Tanja Daniela Grauvogel1, Paul Engelskirchen1, Wiebke Semper-Hogg2
1Department of Otorhinolaryngology-Head and Neck Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Plos One
|July 13, 2017
Summary
Navigation accuracy in ENT surgery varies by anatomical region. A hybrid registration technique significantly improves accuracy for skull base procedures, while non-invasive mask registration is effective for the midface.
Area of Science:
- Neurosurgery
- Otolaryngology
- Medical Imaging
- Surgical Navigation
Background:
- Computer-aided surgery enhances precision in ENT procedures, particularly sinus surgery.
- Current navigation accuracy limitations exist for complex skull base operations.
- Region-specific accuracy data is crucial for optimizing surgical navigation.
Purpose of the Study:
- To evaluate the impact of a hybrid registration technique on navigation accuracy in specific anatomical regions during ENT surgery.
- To compare the accuracy of screw registration, LED-mask registration, and hybrid registration methods.
- To determine optimal registration strategies for different anatomical sites in computer-aided surgery.
Main Methods:
- An experimental phantom study was conducted in an operating room setting.
- Three registration techniques were compared: gold standard screw registration, automatic LED-mask registration, and hybrid registration (mask + surface matching).
- Accuracy was assessed using 3D-printed skull models with silicone skin, measuring overall and region-specific navigation accuracy across 26 fiducials.
Main Results:
- Overall navigation accuracy was below 1.0 mm for all methods.
- Screw registration yielded the highest accuracy (0.66 ± 0.08 mm), followed by hybrid (0.83 ± 0.08 mm) and mask registration (0.92 ± 0.13 mm).
- Screw registration excelled in the sphenoid sinus and internal auditory canal, while mask registration was superior on the midface. Hybrid registration significantly improved accuracy for skull base procedures.
Conclusions:
- Overall navigation accuracy metrics do not fully represent accuracy in distinct anatomical areas.
- Non-invasive LED-mask registration is a viable alternative for midface procedures.
- Hybrid registration is recommended for challenging skull base surgeries to enhance navigation precision, with invasive methods reserved for highly complex cases requiring utmost accuracy.
