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[导航鼻内镜鼻窦手术中的LED自动配准]

[LED autoregistration in navigated endonasal sinus surgery].

作者信息

Arapakis I, Hubbe U, Maier W, Laszig R, Schipper J

机构信息

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg.

出版信息

Laryngorhinootologie. 2005 Jun;84(6):418-25. doi: 10.1055/s-2004-825998.

Abstract

BACKGROUND

In endonasal sinus surgery, computer aided surgery (CAS) is a generally accepted method. Applying CAS, there are basic problems with the constancy of accuracy at a free mobile patient head as well as with extended referencing time. The navigation system manufacturer Stryker-Leibinger invented together with our working group a non-invasive, frameless, automatic patient registration and simultaneous tracking system for navigated endonasal sinus surgery. With this new user-friendly system it concerns an active, LED-based, self-adhesive on the surface of splanchnocranium autoregistration mask.

MATERIAL AND METHOD

The LED autoregistration mask was tested in an anatomic cadaver study and an ongoing clinical patient study regarding manageability, applicability and accuracy. Accuracy measurements were accomplished on different control points of the head in the cadaver study. The determination of accuracy was calculated with the metric Euclidean distance. Further we report on our experiences with a total of 20 patients applying the new mask. To control the accuracy, anatomic landmarks of the patients were adducted. Goal of our study was to determine the accuracy of the LED mask and to compare it with titanium screw markers, the valid reference gold standard.

RESULTS

The LED autoregistration mask convinced by a high precision with relatively simple useability. Total accuracy amounted to 2.22 +/- 0.91 mm. The LED system proved to be a valuable orientation guide mainly at revision surgeries with modified anatomy.

CONCLUSIONS

LED surface autoregistration is especially suitable for endonasal sinus surgery and represents a very helpful tool for the rhinosurgeon. Our accuracy studies have shown that the LED autoregistration mask is comparable to the gold standard titanium screw markers and, in addition, very reliable.

摘要

背景

在鼻内鼻窦手术中,计算机辅助手术(CAS)是一种普遍接受的方法。应用CAS时,存在患者头部自由移动时精度稳定性以及参考时间延长等基本问题。导航系统制造商史赛克-莱宾格与我们的工作组共同发明了一种用于导航鼻内鼻窦手术的非侵入性、无框架、自动患者注册和同步跟踪系统。对于这个新的用户友好系统,它涉及一种基于LED的、可自粘在面颅骨表面的主动式自动注册面罩。

材料与方法

在一项解剖尸体研究和一项正在进行的临床患者研究中,对LED自动注册面罩的可操作性、适用性和准确性进行了测试。在尸体研究中,在头部的不同控制点进行了精度测量。精度的测定采用欧几里得距离度量法计算。此外,我们报告了总共20例应用新面罩的患者的经验。为了控制精度,纳入了患者的解剖标志点。我们研究的目的是确定LED面罩的精度,并将其与钛螺钉标记物(有效的参考金标准)进行比较。

结果

LED自动注册面罩以相对简单的可用性和高精度令人信服。总精度为2.22 +/- 0.91毫米。LED系统在解剖结构改变的翻修手术中被证明是一个有价值的定位指南。

结论

LED表面自动注册特别适用于鼻内鼻窦手术,是鼻科医生非常有用的工具。我们的精度研究表明,LED自动注册面罩与金标准钛螺钉标记物相当,而且非常可靠。

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