Automatic Registration for Navigation at the Anterior and Lateral Skull Base

2019 ◽  
Vol 128 (10) ◽  
pp. 894-902 ◽  
Author(s):  
Julia Kristin ◽  
Manuel Burggraf ◽  
Dirk Mucha ◽  
Christoph Malolepszy ◽  
Silvan Anderssohn ◽  
...  
Keyword(s):  
Skull Base ◽  
Navigation System ◽  
Automatic Registration ◽  
Total N ◽  
Electromagnetic Navigation ◽  
Registration Error ◽  
Target Registration Error ◽  
Lateral Skull Base ◽  
Significant Difference ◽  
Electromagnetic Navigation System

Objective: Navigation systems create a connection between imaging data and intraoperative situs, allowing the surgeon to consistently determine the location of instruments and patient anatomy during the surgical procedure. The best results regarding the target registration error (measurement uncertainty) are normally demonstrated using fiducials. This study aimed at investigating a new registration strategy for an electromagnetic navigation device. Methods: For evaluation of an electromagnetic navigation system and comparison of registration with screw markers and automatic registration, we are calculating the target registration error in the region of the paranasal sinuses/anterior and lateral skull base with the use of an electromagnetic navigation system and intraoperative digital volume tomography (cone-beam computed tomography). We carried out 10 registrations on a head model (total n = 150 measurements) and 10 registrations on 4 temporal bone specimens (total n = 160 measurements). Results: All in all, the automatic registration was easy to perform. For the models that were used, a significant difference between an automatic registration and the registration on fiducials was evident for just a limited number of screws. Furthermore, the observed differences varied in terms of the preferential registration procedure. Conclusion: The automatic registration strategy seems to be an alternative to the established methods in artificial and cadaver models of intraoperative scenarios. Using intraoperative imaging, there is an option to resort to this kind of registration as needed.

The accuracy of an electromagnetic navigation system in lateral skull base approaches

2016 ◽  
Vol 127 (2) ◽  
pp. 450-459 ◽  
Author(s):  
Noritaka Komune ◽  
Ken Matsushima ◽  
Satoshi Matsuo ◽  
Sam Safavi-Abbasi ◽  
Nozomu Matsumoto ◽  
...  
Keyword(s):  
Skull Base ◽  
Navigation System ◽  
Electromagnetic Navigation ◽  
Lateral Skull Base ◽  
Electromagnetic Navigation System

Electromagnetic Navigation Systems and Intraoperative Neuromonitoring: Reliability and Feasibility Study

2021 ◽  
Vol 20 (4) ◽  
pp. 373-382
Author(s):  
Hannah Keeble ◽  
José Pedro Lavrador ◽  
Noémia Pereira ◽  
Kornelius Lente ◽  
Christian Brogna ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Navigation System ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Motor Deficit ◽  
Neurophysiological Monitoring ◽  
Navigation Systems ◽  
Electromagnetic Navigation ◽  
Significant Difference ◽  
Electromagnetic Navigation System

Abstract BACKGROUND A recent influx of intraoperative technology is being used in neurosurgery, but few reports investigate the accuracy and safety of these technologies when used simultaneously. OBJECTIVE To assess the ability to use an electromagnetic navigation system alongside multimodal intraoperative neurophysiological monitoring (IONM). METHODS Single-institution prospective cohort study of patients requiring craniotomy for brain tumor resection operated using an electromagnetic navigation system (AxiEM, Medtronic®). motor evoked potentials, somatosensory evoked potentials (SSEPs), electroencephalography, and electromyography were recorded and analyzed with AxiEM on (with/without filters) and off. The neurological outcomes of the patients were recorded. RESULTS A total of 15 patients were included (8 males/7 females, mean age 52.13 yr). Even though the raw acquisition is affected by the electromagnetic field (particularly SSEPs), no significant difference was detected in the morphology, amplitude, and latency of the different monitoring modalities (AxiEM off vs on) after the appropriate software filter application. Adjustments to the frequency of SSEP stimulation and number of averages, and reductions to the low-pass filters were applied. Notch filters were used appropriately and changes to the physical setup of the IONM and electromagnetic navigation system equipment reduced noise. Postoperatively, none of the patients developed new focal deficits; 7 patients showed improvement in their motor deficit (4 recovered fully). CONCLUSION The information provided by the IONM in intracranial neurosurgery patients whilst also using electromagnetic navigation systems is reliable for monitoring, mapping, and detecting intraoperative complications, provided that the appropriate software filters and tools are applied.

scholarly journals Audit of Complications in an Otolaryngology Led Skull-Base Surgical Practice

2018 ◽  
Vol 80 (06) ◽  
pp. 586-592
Author(s):  
Uma Patnaik ◽  
Smriti Panda ◽  
Alok Thakar
Keyword(s):  
Skull Base ◽  
Surgical Complications ◽  
Skull Base Surgery ◽  
Major Complication ◽  
Anterior Skull Base ◽  
Complication Rates ◽  
Permanent Disability ◽  
Lateral Skull Base ◽  
Significant Difference ◽  
Surgical Complexity

Objective This study was aimed to classify and study complications of surgery of the cranial base, primarily from an otorhinolaryngology perspective. Design This study was designed with consecutive cohort of skull base surgical cases. Setting Tertiary referral academic center. Participants Patients having skull-base surgery at a otorhinolaryngology based skull-base unit, from 2002 to 2015. Main Outcome Measures Enumeration of complications is the main outcome of this study. Surgical procedures, categorized for complexity as per a unified system, are applicable to endoscopic and open procedures. Complications were categorized as per the British Association of Otolaryngologists coding of surgical complications. Complication classified as major if life-threatening, causing permanent disability, or compromising the result of surgery. Results A total of 342 patients (n = 342) were operated; 13 patients' records were excluded due to < 6 months posttreatment follow-up. The study group constituted 204 anterior skull-base (endoscopic, 120; open/external, 84) and 125 lateral skull-base procedures. Complication rates noted to increase in both groups with increasing complexity of surgical intervention. Anterior skull-base surgery (total complications, 11%; major, 3%; death, 0.5%) noted to have significantly less surgical complications than lateral skull-base surgery (total complications, 33%; major, 15%; death, 1.6%; p < 0.001). Among the anterior procedures no significant difference noted among endoscopic and external approaches when compared across similar surgical complexity. Conclusion Despite improvement in surgical and perioperative care, the overall major complication rate in a contemporary otolaryngology led, primarily extradural, skull-base practice is noted at 8%. Perioperative mortality, though rare, was encountered in 1%. A standard method for categorization of surgical complexity and the grade of complications as reported here is recommended.

CT guidance assisted by electromagnetic navigation system for percutaneous fixation by internal cemented screws (FICS)

2019 ◽  
Vol 30 (2) ◽  
pp. 943-949 ◽  
Author(s):  
Benjamin Moulin ◽  
Lambros Tselikas ◽  
Thierry De Baere ◽  
Florent Varin ◽  
Abdellahi Abed ◽  
...  
Keyword(s):  
Navigation System ◽  
Ct Guidance ◽  
Percutaneous Fixation ◽  
Electromagnetic Navigation ◽  
Electromagnetic Navigation System
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