Computer-assisted Surgery With Bone Anchoring in Otologic Surgery

Area of Science:

• Neurosurgery
• Medical Technology
• Anatomy

Background:

• Computer-assisted navigation (CAN) is gaining traction in ENT surgeries, including sinus and otoneurosurgery.
• Accurate navigation is crucial for complex procedures like temporal bone surgery.

Purpose of the Study:

• To evaluate the accuracy of a specific CAN system in temporal bone surgery.
• To assess the system's performance using bone-anchored registration without preoperative fiducial markers or facial CT.

Main Methods:

• Ten cadaveric temporal bones were dissected using the Collin Navigation Solutions system.
• Surface registration was performed using the iterative closest point (ICP) algorithm and 3 anatomic landmarks.
• Positional accuracy (PA) was measured for the incus (INC), malleus (MAL), round window (COC), and lateral semicircular canal (LSC).

Main Results:

• Initial positional accuracy (PA) was sub-millimeter (<1 mm) in 77.5% of measurements.
• Mean PA improved from 0.67 ± 0.46 mm to 0.44 ± 0.32 mm after re-registration.
• Significant accuracy improvements were noted for the lateral semicircular canal (LSC) and incus (INC) after re-registration.

Conclusions:

• The CAN system demonstrates encouraging accuracy for temporal bone surgery.
• Bone-anchored registration offers a viable alternative for navigation in this surgical field.
• Further research is warranted to explore the full potential of CAN in temporal bone procedures.