Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Int J Comput Assist Radiol Surg. 2009 May;4(3):273-80. doi: 10.1007/s11548-009-0292-3. Epub 2009 Feb 28.
To introduce a novel microstereotactic frame, called the Microtable, consisting of a tabletop that mounts on bone-implanted spherical markers. The microtable is customized for individual patient anatomy to guide a surgical instrument to a specified target.
Fiducial markers are bone-implanted, and CT scanning is performed. A microtable is custom-designed for the location of the markers and the desired surgical trajectory and is constructed using a computer-numerical-control machine. Validation studies were performed on phantoms with geometry similar to that for cochlear implant surgery. Two designs were tested with two different types of fiducial markers.
Mean targeting error of the microtables for the two designs were 0.37 +/- 0.18 and 0.60 +/- 0.21 mm (n = 5). Construction of each microtable required approximately 6 min.
The new frame achieves both high accuracy and rapid fabrication. We are currently using the microtable for clinical testing of the concept of percutaneous cochlear implant surgery.
介绍一种新型微立体定向框架,称为 Microtable,由安装在骨植入球形标记物上的桌面组成。该微桌根据患者个体解剖结构定制,用于引导手术器械到达特定的目标。
将基准标记物植入骨中,并进行 CT 扫描。根据标记物的位置和所需的手术轨迹定制微桌,并使用数控机床构建。使用与人工耳蜗植入手术类似的几何形状的体模进行验证研究。使用两种不同类型的基准标记物测试了两种设计。
两种设计的微桌的平均目标误差分别为 0.37 +/- 0.18 和 0.60 +/- 0.21 毫米(n = 5)。每个微桌的构建大约需要 6 分钟。
新型框架实现了高精度和快速制造。我们目前正在使用微桌进行经皮人工耳蜗植入手术概念的临床测试。