Marmulla Rüdiger, Lüth Tim, Mühling Joachim, Hassfeld Stefan
Department of Cranio-Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
J Oral Maxillofac Surg. 2004 Jul;62(7):845-51. doi: 10.1016/j.joms.2004.01.014.
The use of registration markers in computer-assisted surgery is combined with high logistic costs and efforts. Markerless patient registration using laser scan surface registration techniques is a new challenging method. The present study was performed to evaluate the clinical accuracy in finding defined target points within the surgical site after markerless patient registration in image-guided oral and maxillofacial surgery.
Twenty consecutive patients with different cranial diseases were scheduled for computer-assisted surgery. Data set alignment between the surgical site and the computed tomography (CT) data set was performed by markerless laser scan surface registration of the patient's face. Intraoral rigidly attached registration markers were used as target points, which had to be detected by an infrared pointer. The Surgical Segment Navigator SSN++ has been used for all procedures. SSN++ is an investigative product based on the SSN system that had previously been developed by the presenting authors with the support of Carl Zeiss (Oberkochen, Germany). SSN++ is connected to a Polaris infrared camera (Northern Digital, Waterloo, Ontario, Canada) and to a Minolta VI 900 3D digitizer (Tokyo, Japan) for high-resolution laser scanning.
Minimal differences in shape between the laser scan surface and the surface generated from the CT data set could be detected. Nevertheless, high-resolution laser scan of the skin surface allows for a precise patient registration (mean deviation 1.1 mm, maximum deviation 1.8 mm).
Radiation load, logistic costs, and efforts arising from the planning of computer-assisted surgery of the head can be reduced because native (markerless) CT data sets can be used for laser scan-based surface registration.
在计算机辅助手术中使用注册标记物会带来高昂的后勤成本和工作量。采用激光扫描表面注册技术的无标记患者注册是一种新的具有挑战性的方法。本研究旨在评估在图像引导的口腔颌面外科手术中，无标记患者注册后在手术部位找到定义的目标点的临床准确性。
连续20例患有不同颅脑疾病的患者计划接受计算机辅助手术。通过对患者面部进行无标记激光扫描表面注册，实现手术部位与计算机断层扫描（CT）数据集之间的数据集对齐。口内刚性附着的注册标记物用作目标点，必须通过红外指针进行检测。所有手术均使用手术段导航器SSN++。SSN++是一种基于SSN系统的研究产品，该系统先前由本文作者在德国奥伯科亨的卡尔蔡司公司的支持下开发。SSN++连接到一台北极星红外相机（加拿大安大略省滑铁卢的北方数字公司）和一台Minolta VI 900 3D数字化仪（日本东京），用于高分辨率激光扫描。
可以检测到激光扫描表面与CT数据集生成的表面之间在形状上的微小差异。尽管如此，对皮肤表面进行高分辨率激光扫描可实现精确的患者注册（平均偏差1.1毫米，最大偏差1.8毫米）。
由于可以使用原始（无标记）CT数据集进行基于激光扫描的表面注册，因此可以降低头部计算机辅助手术规划中的辐射负荷、后勤成本和工作量。
