Copenhagen Hearing and Balance Center, Department of Otorhinolaryngology, Rigshospitalet, Copenhagen, Denmark.
Department of Biomedical Informatics, Ohio State University, Columbus, Ohio, U.S.A.
Laryngoscope. 2024 Mar;134(3):1403-1409. doi: 10.1002/lary.31016. Epub 2023 Aug 31.
Patient-specific virtual reality (VR) simulation of cochlear implant (CI) surgery potentially enables preoperative rehearsal and planning. We aim to gather supporting validity evidence for patient-specific simulation through the analysis of virtual performance and comparison with postoperative imaging.
Prospective, multi-institutional study. Pre- and postoperative cone-beam CT scans of CI surgical patients were obtained and processed for patient-specific VR simulation. The virtual performances of five trainees and four attendings were recorded and (1) compared with volumes removed during actual surgery as determined in postoperative imaging, and (2) assessed using the Copenhagen Cochlear Implant Surgery Assessment Tool (CISAT) by two blinded raters. The volumes compared were cortical mastoidectomy, facial recess, and round window (RW) cochleostomy as well as violation of the facial nerve and chorda.
Trainees drilled more volume in the cortical mastoidectomy and facial recess, whereas attendings drilled more volume for the RW cochleostomy and made more violations. Except for the cochleostomy, attendings removed volumes closer to that determined in postoperative imaging. Trainees achieved a higher CISAT performance score compared with attendings (22.0 vs. 18.4 points) most likely due to lack of certain visual cues.
We found that there were differences in performance of trainees and attendings in patient-specific VR simulation of CI surgery as assessed by raters and in comparison with actual drilled volumes. The presented approach of volume comparison is novel and might be used for further validation of patient-specific VR simulation before clinical implementation for preoperative rehearsal in temporal bone surgery.
n/a Laryngoscope, 134:1403-1409, 2024.
患者特定的虚拟现实（VR）模拟耳蜗植入（CI）手术有可能实现术前排练和规划。我们旨在通过分析虚拟性能并与术后成像进行比较，为患者特定的模拟收集支持有效性的证据。
前瞻性、多机构研究。获取并处理 CI 手术患者的术前和术后锥形束 CT 扫描，以进行患者特定的 VR 模拟。记录了五名学员和四名主治医生的虚拟表现，并（1）与术后成像中确定的实际手术中切除的体积进行比较，（2）由两名盲审员使用哥本哈根耳蜗植入手术评估工具（CISAT）进行评估。比较的体积包括皮质乳突切除术、面神经隐窝和圆窗（RW）耳蜗造口术，以及面神经和面神经的侵犯。
学员在皮质乳突切除术和面神经隐窝中钻取的体积更大，而主治医生在 RW 耳蜗造口术和侵犯面神经和面神经方面钻取的体积更大。除了耳蜗造口术之外，主治医生切除的体积更接近术后成像确定的体积。学员的 CISAT 表现评分高于主治医生（22.0 分与 18.4 分），这可能是由于缺乏某些视觉线索。
我们发现，在评估者评估和与实际钻孔体积比较方面，学员和主治医生在 CI 手术患者特定 VR 模拟中的表现存在差异。所提出的体积比较方法是新颖的，可能用于在 temporal bone 手术中进行术前排练之前，进一步验证患者特定的 VR 模拟。
无。喉镜，134:1403-1409，2024。
