Related Experiment Video
Updated: May 10, 2025
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Intraoperative measurements in stapedotomy using 3D stereo imaging for optimal prosthesis length selection
Eric L Wisotzky1, Felix Lausch2, Linus L Kienle3
1Computer Vision & Graphics, Vision and Imaging Technologies, Fraunhofer Heinrich Hertz Institut, HHI, Berlin, Germany; Institute of Informatics, Humboldt Universität zu Berlin, Germany; Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Germany.
This study introduces 3D stereoscopic imaging for precise surgical measurements in stapedotomy, offering a radiation-free alternative. The technique accurately guided prosthesis selection, leading to significant hearing improvement in patients.
Area of Science:
- Otolaryngology
- Medical Imaging
- Surgical Technology
Background:
- Precise intraoperative measurements are vital in microsurgery, but conventional methods using microscopic zoom lenses often lack accuracy.
- 3D stereoscopic imaging offers a non-contact, radiation-free method for anatomical measurements, potentially overcoming limitations of traditional techniques.
Purpose of the Study:
- To investigate the accuracy and clinical applicability of 3D stereoscopic imaging within a digital microscope for stapedotomy.
- To evaluate the method's effectiveness in selecting optimal prosthesis lengths and its impact on surgical outcomes.
Main Methods:
- An optimized calibration scheme for stereoscopic zoom-focus systems was developed and applied across various magnification levels.
- 23 patients undergoing stapedotomy were included, utilizing stereo imaging for landmark annotation and prosthesis measurement.
- Sub-millimeter accuracy was achieved, with an average deviation of 0.2097 ± 0.1598 mm.
Main Results:
- The 3D imaging technique demonstrated sub-millimeter accuracy in prosthesis length measurements.
- A significant correlation was found between prosthesis insertion depth and postoperative audiological outcomes.
- Patients experienced a mean air-bone gap improvement of 19.1 dB [HL], confirming clinical efficacy.
Conclusions:
- 3D stereoscopic imaging provides a radiation-free, accurate, and efficient alternative for intraoperative measurements in stapedotomy.
- This technology enhances surgical precision, improves patient outcomes, and has potential for future automated real-time measurements.
- The study validates the clinical efficacy of 3D imaging in otologic surgery, paving the way for wider adoption and further research.
