Labadie Robert F, Shah Rohan J, Harris Steve S, Cetinkaya Ebru, Haynes David S, Fenlon Michael R, Juscyzk Andrzej S, Galloway Robert L, Fitzpatrick J Michael
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2559, USA.
Comput Aided Surg. 2004;9(4):145-53. doi: 10.3109/10929080500066922.
Otologic surgery is undertaken to treat ailments of the ear, including persistent infections, hearing loss, vertigo, and cancer. Typically performed on otherwise-healthy patients in outpatient facilities, the application of image-guided surgery (IGS) has been limited because accurate (<1 mm), non-invasive fiducial systems for otologic surgery have not been available. We now present such a fiducial system.
A dental bite-block was fitted with a custom-designed rigid frame with 7 fiducial markers surrounding each external ear. The bones containing the ear (i.e., the temporal bones) of 3 cadaveric skulls were removed and replaced with discs containing 13 surgical targets arranged in a cross-hair pattern about the centroid of each ear. The surgical targets (26/skull) and fiducial markers (14/skull) were identified both within CT scans using a published algorithm and in physical space using an infrared optical tracking system. Fiducial registration error (FRE), fiducial localization error (FLE), and target registration error (TRE) were calculated.
For all trials, root mean square FRE = 0.66, FLE = 0.72, and TRE = 0.77 mm. The mean TRE for n = 234 independent targets was 0.73 with a standard deviation of 0.25 mm.
Using a novel, non-invasive fiducial system (the EarMark), submillimetric accuracy was repeatably achieved. This system will facilitate image-guided otologic surgery.
耳科手术旨在治疗耳部疾病，包括持续性感染、听力损失、眩晕和癌症。耳科手术通常在门诊为其他方面健康的患者进行，图像引导手术（IGS）的应用一直受到限制，因为尚无用于耳科手术的精确（<1毫米）、非侵入性基准系统。我们现在介绍这样一种基准系统。
在一个牙咬块上安装一个定制设计的刚性框架，框架上有7个基准标记环绕每只外耳。从3个尸体颅骨上移除包含耳朵的骨头（即颞骨），并用包含13个手术靶点的圆盘替换，这些靶点围绕每只耳朵的质心以十字准线模式排列。使用已发表的算法在CT扫描中以及使用红外光学跟踪系统在物理空间中识别手术靶点（每个颅骨26个）和基准标记（每个颅骨14个）。计算基准配准误差（FRE）、基准定位误差（FLE）和靶点配准误差（TRE）。
在所有试验中，均方根FRE = 0.66，FLE = 0.72，TRE = 0.77毫米。n = 234个独立靶点的平均TRE为0.73，标准差为0.25毫米。
使用一种新型的非侵入性基准系统（EarMark），可重复实现亚毫米级精度。该系统将有助于图像引导的耳科手术。
