Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
Eur Rev Med Pharmacol Sci. 2022 Mar;26(5):1674-1682. doi: 10.26355/eurrev_202203_28236.
This prospective study compared the accuracy of two different company-specific registration methods (Fiagon GmbH, Hennigsdorf, Germany) in the electromagnetic navigation of the frontal skull base. A newly developed photo registration technology (Fiagon tracey©) promises an increase in accuracy and user-friendliness, but there is no phantom-based prospective study comparing the new method with the classic approach of tactile surface registration.
A phantom skull was prepared with 27 markers in the sagittal, axial and coronary planes, and their reference coordinates were determined using a navigational CT (low dose, slice 0.6 mm). Subsequently, 20 runs of automatic photo registration and tactile surface registration were carried out, and the resulting marker coordinates were compared with the reference coordinates. The target registration error (TRE) of the 27 markers was assessed and compared between the two methods using a 2-factor ANOVA with repeated measures.
The mean TRE using surface registration was 1.97 mm ± 0.57, while the mean TRE of the automatic photo registration was 1.54 mm ± 0.24 (p < 0.001). In a subgroup analysis limited to markers in anatomical regions of clinical relevance in terms of paranasal sinus surgery, the mean TRE for the photo registration procedure can even be reduced to 1.29 mm (± 0.43) compared to tactile registration (1.80 mm; ±0.50; p=0.01).
Photo registration is a promising new technology in the field of electromagnetic navigation in paranasal sinus surgery. This prospective phantom-based study showed that the photo registration method achieves a significantly lower target registration error (1.29 mm) compared to the surface-based tactile registration procedure (1.80 mm).
本前瞻性研究比较了两种不同公司特定注册方法（德国亨尼希多夫的 Fiagon 有限公司）在额颅底电磁导航中的准确性。新开发的照片注册技术（Fiagon tracey©）有望提高准确性和用户友好性，但没有基于幻影的前瞻性研究将新方法与经典的触觉表面注册方法进行比较。
使用矢状面、轴面和冠状面的 27 个标记物制备幻影颅骨，并使用导航 CT（低剂量，层厚 0.6mm）确定其参考坐标。随后，进行了 20 次自动照片注册和触觉表面注册运行，并比较了得到的标记物坐标与参考坐标。使用具有重复测量的两因素方差分析评估并比较了两种方法的 27 个标记物的靶标注册误差（TRE）。
使用表面注册的平均 TRE 为 1.97mm±0.57，而自动照片注册的平均 TRE 为 1.54mm±0.24（p<0.001）。在仅限于鼻窦手术中具有解剖学意义的解剖区域的标记物的亚组分析中，与触觉注册（1.80mm；±0.50；p=0.01）相比，照片注册程序的平均 TRE 甚至可以降低至 1.29mm（±0.43）。
照片注册是鼻窦手术电磁导航领域的一项有前途的新技术。这项基于幻影的前瞻性研究表明，与基于表面的触觉注册程序（1.80mm）相比，照片注册方法的靶标注册误差（1.29mm）显著降低。
