Distance Control and Virtual Drilling Improves Anatomical Orientation During Anterior Petrosectomy

Area of Science:

• Neurosurgery
• Surgical Navigation
• Medical Device Technology

Background:

• A new method combining drill distance control and virtual drilling image guidance feedback was developed.
• This addresses the need for improved precision and safety in complex skull base surgeries.

Purpose of the Study:

• To evaluate if the new method improves surgical orientation and performance during anterior petrosectomy (AP).
• To assess the accuracy of virtual drilling and the clinical feasibility of the feedback method.

Main Methods:

• A simulated trial using cadavers with 5 expert surgeons compared the feedback method against standard image guidance for anterior petrosectomy (AP).
• Outcomes measured included damage to critical structures, operating time, drill cavity accuracy, and proximity to the cochlea and acoustic meatus.
• The method was also tested in a clinical setting during AP.

Main Results:

• Surgeons reported significantly better intraoperative orientation with the feedback method.
• The feedback group avoided cochlear and acoustic meatus injury, unlike the control group which caused cochlear damage once.
• Virtual drilling errors averaged 2.2 ± 0.2 mm (underestimation) and -3.0 ± 0.6 mm (overestimation).
• The method demonstrated proper function in the clinical setup.

Conclusions:

• The developed feedback method enhances surgeon orientation and surgical performance in experimental settings.
• Virtual drilling inaccuracies correlate with the image guidance system's spatial errors.
• The feedback method is clinically practical for anterior petrosectomy (AP).