scholarly journals An Automated Methodology for Assessing Anatomy-Specific Instrument Motion during Endoscopic Endonasal Skull Base Surgery

2016 ◽  
Vol 38 (03) ◽  
pp. 222-226 ◽  
Author(s):  
R. Harbison ◽  
Yangming Li ◽  
Angelique Berens ◽  
Randall Bly ◽  
Blake Hannaford ◽  
...  
Keyword(s):  
Angular Velocity ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Tracking System ◽  
Geometric Mean ◽  
Case Series ◽  
Optical Tracking ◽  
Mean Velocity ◽  
Optical Tracking System ◽  
Nasal Vestibule

Objectives Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design Case series. Setting Tertiary academic center. Participants A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions. Results We observed mean (standard deviation, SD) velocities of 6.14 cm/s (1.55) in the nasal vestibule versus 1.65 cm/s (0.34) near the lOCR. Mean (SD) acceleration was 7,480 cm/s2 (5790) in the vestibule versus 928 cm/s2 (662) near the lOCR. Mean (SD) angular velocity was 17.2 degrees/s (8.31) in the vestibule and 5.37 degrees/s (1.09) near the lOCR. We observed a decreasing trend in the geometric mean velocity, acceleration, and angular velocity when approaching the pituitary (p < 0.001). Conclusion Using a novel method for analyzing instrument motion during live ESBS, we observed a decreasing trend in kinematics with proximity to the pituitary. Additional characterization of surgical instrument motion is paramount for optimizing patient safety and training.

scholarly journals Quantitative Analysis of Surgical Working Space During Endoscopic Skull Base Surgery

2018 ◽  
Vol 80 (05) ◽  
pp. 469-473
Author(s):  
Joel C. Davies ◽  
Harley H.L. Chan ◽  
Christopher M.K.L. Yao ◽  
Michael D. Cusimano ◽  
Jonathan C Irish ◽  
...  
Keyword(s):  
Skull Base ◽  
Tracking System ◽  
Statistical Significance ◽  
Optical Tracking ◽  
Cone Beam ◽  
Optical Tracking System ◽  
Significance Level ◽  
Working Space ◽  
Computed Tomography Scans ◽  
Transphenoidal Approach

Abstract Objectives Selective dissection of intranasal anatomy may improve visualization and maneuverability at the skull base. We aimed to quantify the dimensions of working space and angles achieved following sequential removal of intranasal structures using an endoscopic transphenoidal approach to the skull base. Methods Cone beam computed tomography scans of four cadaveric heads were obtained for registration of an optical tracking system. Each head was sequentially dissected: (1) sphenoidotomy and limited posterior septectomy, (2) unilateral partial middle turbinectomy, (3) bilateral partial middle turbinectomy, and (4) wide posterior septectomy. The maximal craniocaudal and mediolateral distance (mm) and angle (degrees) reached were calculated at the sphenoid face and sella. Data were analyzed using descriptive statistics and tests of statistical significance. The significance level was set at p  ≤  0.05. Results A significant improvement in both dimensions of working space was observed with each stage of dissection at the level of the sphenoid face. Maximal working space was achieved following bilateral middle turbinectomy and wide posterior septectomy with a 38 and 29% increase in working space in the mediolateral and craniocaudal dimensions, respectively. The largest stepwise increase in working space was observed with unilateral middle turbinectomy (mediolateral: 24 ± 3 mm and craniocaudal: 20 ± 3 mm). A trend toward improved degrees of visualization was observed with each stage of dissection but was not statistically significant. Conclusion Approaches to the skull base can be enhanced by selective unilateral/bilateral partial middle turbinectomy and posterior septectomy being performed to improve visualization and maximize surgical working freedom.

scholarly journals First experience with augmented reality neuronavigation in endoscopic assisted midline skull base pathologies in children

2021 ◽  
Author(s):  
Valentina Pennacchietti ◽  
Katharina Stoelzel ◽  
Anna Tietze ◽  
Erwin Lankes ◽  
Andreas Schaumann ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Morphological Variability ◽  
Case Series ◽  
Relevant Information ◽  
Navigation Systems ◽  
Postoperative Mri ◽  
The Mean ◽  
Clinical Conditions

Abstract Introduction Endoscopic skull base approaches are broadly used in modern neurosurgery. The support of neuronavigation can help to effectively target the lesion avoiding complications. In children, endoscopic-assisted skull base surgery in combination with navigation systems becomes even more important because of the morphological variability and rare diseases affecting the sellar and parasellar regions. This paper aims to analyze our first experience on augmented reality navigation in endoscopic skull base surgery in a pediatric case series. Patients and methods A retrospective review identified seventeen endoscopic-assisted endonasal or transoral procedures performed in an interdisciplinary setting in a period between October 2011 and May 2020. In all the cases, the surgical target was a lesion in the sellar or parasellar region. Clinical conditions, MRI appearance, intraoperative conditions, postoperative MRI, possible complications, and outcomes were analyzed. Results The mean age of our patients was 14.5 ± 2.4 years. The diagnosis varied, but craniopharyngiomas (31.2%) were mostly represented. AR navigation was experienced to be very helpful for effectively targeting the lesion and defining the intraoperative extension of the pathology. In 65% of the oncologic cases, a radical removal was proven in postoperative MRI. The mean follow-up was 89 ± 79 months. There were no deaths in our series. No long-term complications were registered; two cerebrospinal fluid (CSF) fistulas and a secondary abscess required further surgery. Conclusion The implementation of augmented reality to endoscopic-assisted neuronavigated procedures within the skull base was feasible and did provide relevant information directly in the endoscopic field of view and was experienced to be useful in the pediatric cases, where anatomical variability and rarity of the pathologies make surgery more challenging.

scholarly journals In Vitro and In Vivo Assessment of a New Workflow for the Acquisition of Mandibular Kinematics Based on Portable Tracking System with Passive Optical Reflective Markers

2021 ◽  
Vol 11 (9) ◽  
pp. 3947
Author(s):  
Marco Farronato ◽  
Gianluca M. Tartaglia ◽  
Cinzia Maspero ◽  
Luigi M. Gallo ◽  
Vera Colombo
Keyword(s):  
Measurement Error ◽  
Tracking System ◽  
Intraclass Correlation ◽  
Optical Tracking ◽  
Optical Tracking System ◽  
Rater Reliability ◽  
Tracking Device ◽  
Mandibular Kinematics

Clinical use of portable optical tracking system in dentistry could improve the analysis of mandibular movements for diagnostic and therapeutic purposes. A new workflow for the acquisition of mandibular kinematics was developed. Reproducibility of measurements was tested in vitro and intra- and inter-rater repeatability were assessed in vivo in healthy volunteers. Prescribed repeated movements (n = 10) in three perpendicular directions of the tracking-device coordinate system were performed. Measurement error and coefficient of variation (CV) among repetitions were determined. Mandibular kinematics of maximum opening, left and right laterality, protrusion and retrusion of five healthy subjects were recorded in separate sessions by three different operators. Obtained records were blindly examined by three observers. Intraclass correlation coefficient (ICC) was calculated to estimate inter-rater and intra-rater reliability. Maximum in vitro measurement error was 0.54 mm and CV = 0.02. Overall, excellent intra-rater reliability (ICC > 0.90) for each variable, general excellent intra-rater reliability (ICC = 1.00) for all variables, and good reliability (ICC > 0.75) for inter-rater tests were obtained. A lower score was obtained for retrusion with “moderate reliability” (ICC = 0.557) in the inter-rater tests. Excellent repeatability and reliability in optical tracking of primary movements were observed using the tested portable tracking device and the developed workflow.

scholarly journals High Precision Optical Tracking System Based on near Infrared Trinocular Stereo Vision

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2528
Author(s):  
Songlin Bi ◽  
Yonggang Gu ◽  
Jiaqi Zou ◽  
Lianpo Wang ◽  
Chao Zhai ◽  
...  
Keyword(s):  
High Precision ◽  
Stereo Vision ◽  
Near Infrared ◽  
Nearest Neighbor ◽  
Tracking System ◽  
Optical Tracking ◽  
Tracking Accuracy ◽  
Optical Tracking System ◽  
Dynamic Tracking ◽  
Trinocular Stereo

A high precision optical tracking system (OTS) based on near infrared (NIR) trinocular stereo vision (TSV) is presented in this paper. Compared with the traditional OTS on the basis of binocular stereo vision (BSV), hardware and software are improved. In the hardware aspect, a NIR TSV platform is built, and a new active tool is designed. Imaging markers of the tool are uniform and complete with large measurement angle (>60°). In the software aspect, the deployment of extra camera brings high computational complexity. To reduce the computational burden, a fast nearest neighbor feature point extraction algorithm (FNNF) is proposed. The proposed method increases the speed of feature points extraction by hundreds of times over the traditional pixel-by-pixel searching method. The modified NIR multi-camera calibration method and 3D reconstruction algorithm further improve the tracking accuracy. Experimental results show that the calibration accuracy of the NIR camera can reach 0.02%, positioning accuracy of markers can reach 0.0240 mm, and dynamic tracking accuracy can reach 0.0938 mm. OTS can be adopted in high-precision dynamic tracking.

scholarly journals Skill Transference of a Probe-Tube Placement Training Simulator

2020 ◽  
Vol 31 (01) ◽  
pp. 040-049 ◽  
Author(s):  
Robert W. Koch ◽  
Hasan Saleh ◽  
Paula Folkeard ◽  
Sheila Moodie ◽  
Conner Janeteas ◽  
...  
Keyword(s):  
Mixed Model ◽  
Tracking System ◽  
Optical Tracking ◽  
Tube Placement ◽  
Control Group ◽  
Educational Settings ◽  
Training Simulator ◽  
Nonlinear Mixed Model ◽  
Optical Tracking System ◽  
Clinical Scenarios

AbstractProbe-tube placement is a necessary step in hearing aid verification which needs ample hands-on experience and confidence before performing in clinic. To improve the methods of training in probe-tube placement, a manikin-based training simulator was developed consisting of a 3D-printed head, a flexible silicone ear, and a mounted optical tracking system. The system is designed to provide feedback to the user on the depth and orientation of the probe tube, and the time required to finish the task. Although a previous validation study was performed to determine its realism and teachability with experts, further validation is required before implementation into educational settings.This study aimed to examine the skill transference of a newly updated probe-tube placement training simulator to determine if skills learned on this simulator successfully translate to clinical scenarios.All participants underwent a pretest in which they were evaluated while performing a probe-tube placement and real-ear-to-coupler difference (RECD) measurement on a volunteer. Participants were randomized into one of two groups: the simulator group or the control group. During a two-week training period, all participants practiced their probe-tube placement according to their randomly assigned group. After two weeks, each participant completed a probe-tube placement on the same volunteer as a posttest scenario.Twenty-five novice graduate-level student clinicians.Participants completed a self-efficacy questionnaire and an expert observer completed a questionnaire evaluating each participant’s performance during the pre- and posttest sessions. RECD measurements were taken after placing the probe tube and foam tip in the volunteer’s ear. Questionnaire results were analyzed through nonparametric t-tests and analysis of variance, whereas RECD results were analyzed using a nonlinear mixed model method.Results suggested students in the simulator group were less likely to contact the tympanic membrane when placing a probe tube, appeared more confident, and had better use of the occluding foam tip, resulting in more improved RECD measurements.The improved outcomes for trainees in the simulator group suggest that supplementing traditional training with the simulator provides useful benefits for the trainees, thereby encouraging its usage and implementation in educational settings.

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