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Toward automatic atlas-based surgical planning for septoplasty.

Jared Vicory1, Guilherme J M Garcia2,3, John S Rhee2

  • 1Kitware, Inc. Medical Computing Group, Carrboro, NC, USA. jared.vicory@kitware.com.

International Journal of Computer Assisted Radiology and Surgery
|November 27, 2021
PubMed
Summary

This study introduces an automated virtual septoplasty technique to improve nasal airway obstruction surgery. The method successfully straightened septums in 69% of patients, enhancing nasal airway symmetry.

Keywords:
Atlas-based segmentationNasal airway obstructionSeptoplastyVirtual surgery planning

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Area of Science:

  • Medical Imaging
  • Computational Anatomy
  • Surgical Planning

Background:

  • Nasal airway obstruction (NAO) surgery has high failure rates, with persistent symptoms in up to 50% of patients.
  • Current virtual surgery planning methods are labor-intensive, limiting widespread adoption.
  • Improving surgical outcomes for NAO requires efficient and accurate planning tools.

Purpose of the Study:

  • To introduce an automatic atlas-based approach for virtual septoplasty.
  • To automate the process of virtual surgical planning for nasal airway obstruction.
  • To overcome the limitations of manual virtual surgery planning methods.

Main Methods:

  • Developed an automatic atlas-based virtual septoplasty method using a multi-stage registration approach.
  • Constructed a healthy nasal geometry atlas.
  • Applied the method to a cohort of 26 NAO patients and 47 healthy subjects.

Main Results:

  • The automated virtual septoplasty successfully straightened the septum in 18 out of 26 NAO patients (69%).
  • Nasal airway symmetry improved, with the cross-sectional area ratio decreasing from 1.47 to 1.16 in the deviation region.
  • Demonstrated increased symmetry in nasal airways after virtual septoplasty.

Conclusions:

  • The automated virtual septoplasty technique can significantly reduce the effort for computational fluid dynamics (CFD) analysis in NAO surgical planning.
  • This automated approach holds potential for improving surgical planning and outcomes in NAO patients.
  • Further research is needed to correlate virtual surgery planning predictions with subjective patient outcomes post-septoplasty.