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Benchmarking Distance Control and Virtual Drilling for Lateral Skull Base Surgery.
Eduard H J Voormolen1, Sander Diederen2, Marijn van Stralen3
1Department of Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands; Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
World Neurosurgery
|October 3, 2017
Summary
Novel audiovisual feedback, including distance control and virtual drilling, significantly reduces surgical drill damage risk in skull base procedures. These methods enhance safety and are clinically feasible for improved surgical guidance.
Area of Science:
- Neurosurgery
- Surgical Navigation
- Medical Device Technology
Background:
- Developed novel audiovisual feedback methods to enhance image guidance in skull base surgery.
- Implemented distance control for warnings around critical structures and virtual drilling for visualization.
- Aimed to improve safety and accuracy in complex surgical procedures.
Purpose of the Study:
- Benchmark drill damage risk reduction with distance control.
- Quantify the accuracy of virtual drilling visualization.
- Investigate the clinical feasibility of these novel feedback methods.
Main Methods:
- Evaluated distance control in a simulated cadaveric mastoidectomy scenario with inexperienced users.
- Assessed damage to critical structures (sigmoid sinus, facial nerve, semicircular canals).
- Neurosurgeons performed complex approaches, and virtual drilling accuracy was calculated; clinical feasibility was tested in 3 patients.
Main Results:
- Distance control with a 3 mm perimeter eliminated damage to critical structures.
- Smaller perimeters and standard guidance resulted in injuries.
- Virtual drilling showed spatial errors consistent with image guidance system accuracy; feedback methods proved functional in clinical use.
Conclusions:
- Distance control effectively reduces drill damage risk, proportional to the perimeter distance.
- Virtual drilling errors correlate with image guidance system spatial inaccuracies.
- The developed audiovisual feedback methods are clinically feasible and enhance surgical safety.
