Validation of a rhinologic virtual surgical simulator for performing a Draf 3 endoscopic frontal sinusotomy.


Journal

International forum of allergy & rhinology
ISSN: 2042-6984
Titre abrégé: Int Forum Allergy Rhinol
Pays: United States
ID NLM: 101550261

Informations de publication

Date de publication:
08 2019
Historique:
received: 30 09 2018
revised: 17 02 2019
accepted: 24 02 2019
pubmed: 24 4 2019
medline: 24 4 2020
entrez: 24 4 2019
Statut: ppublish

Résumé

We recently introduced a patient-specific rhinologic virtual surgical environment (VSE) that has shown potential for surgical rehearsal of various skull base lesions. Our aim in this study was to validate the usefulness of the rhinology VSE in performing the Draf 3 procedure. An outside-in Draf 3 procedure was performed on 4 cadaver heads. Computed tomography (CT) scans were obtained before and after cadaver dissection (CD). Pre-dissection CT scans were used to construct a cadaver-specific VSE. A virtual Draf 3 dissection (VD) was performed using the same technique. Validation was conducted by comparing the final common frontal outflow tract. A subjective comparison of the post-dissection endoscopic findings (CD vs VD) and an objective measurement using the post-dissection CT scan for the CD and the reconstructed CT scan obtained from the data after the VD was performed. Subjective overall resemblance of the 2 dissections (CD vs VD) assessed by the 4-point Likert scale (0-3) was 2.5 (median interquartile range [IQR], 0.25) for the 4 cadavers. The median difference for the anteroposterior dimension of the frontal neo-ostium (CD vs VD) assessed in the midsagittal view was 0.11 mm, whereas the median difference for the lateral dimension assessed in the coronal view was 2.71 mm. Thus, no statistical difference was observed. VD showed nearly matching results with the actual cadaver dissection. With further validation, our rhinologic VSE may be used for presurgical planning and rehearsal before the actual Draf 3 procedure is performed in the operating room.

Sections du résumé

BACKGROUND
We recently introduced a patient-specific rhinologic virtual surgical environment (VSE) that has shown potential for surgical rehearsal of various skull base lesions. Our aim in this study was to validate the usefulness of the rhinology VSE in performing the Draf 3 procedure.
METHODS
An outside-in Draf 3 procedure was performed on 4 cadaver heads. Computed tomography (CT) scans were obtained before and after cadaver dissection (CD). Pre-dissection CT scans were used to construct a cadaver-specific VSE. A virtual Draf 3 dissection (VD) was performed using the same technique. Validation was conducted by comparing the final common frontal outflow tract. A subjective comparison of the post-dissection endoscopic findings (CD vs VD) and an objective measurement using the post-dissection CT scan for the CD and the reconstructed CT scan obtained from the data after the VD was performed.
RESULTS
Subjective overall resemblance of the 2 dissections (CD vs VD) assessed by the 4-point Likert scale (0-3) was 2.5 (median interquartile range [IQR], 0.25) for the 4 cadavers. The median difference for the anteroposterior dimension of the frontal neo-ostium (CD vs VD) assessed in the midsagittal view was 0.11 mm, whereas the median difference for the lateral dimension assessed in the coronal view was 2.71 mm. Thus, no statistical difference was observed.
CONCLUSION
VD showed nearly matching results with the actual cadaver dissection. With further validation, our rhinologic VSE may be used for presurgical planning and rehearsal before the actual Draf 3 procedure is performed in the operating room.

Identifiants

pubmed: 31012526
doi: 10.1002/alr.22333
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

910-917

Informations de copyright

© 2019 ARS-AAOA, LLC.

Auteurs

Tae-Bin Won (TB)

Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Center for Minimally Invasive Skull Base Surgery, Seoul National University Hospital, Seoul, Korea.

Sung-Woo Cho (SW)

Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Myung-Whun Sung (MW)

Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Hospital, Seoul, Korea.

Sun Ha Paek (SH)

Center for Minimally Invasive Skull Base Surgery, Seoul National University Hospital, Seoul, Korea.
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.

Sonny Chan (S)

Department of Computer Science, University of Calgary, Calgary, AB, Canada.

Kenneth Salisbury (K)

Department of Computer Science, Stanford University, Stanford, CA.

Nikolas H Blevins (NH)

Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, CA.

Yona Vaisbuch (Y)

Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, CA.

Peter Hwang (P)

Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, CA.

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