Minimally Invasive Multiport Surgery of the Lateral Skull Base
Minimally Invasive Multiport Surgery of the Lateral Skull Base
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DOI：
10.1155/2014/379295
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发表时间：
2014-01-01
影响因子：
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通讯作者：
Schipper, Joerg
中科院分区：
文献类型：
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作者：
Stenin, Igor;Hansen, Stefan;Schipper, Joerg
目标。微创手术将医源性组织损伤降至最低，并发症发生率较低，患者满意度较高。到目前为止，仅尝试了经侧颅底的实验性微创单孔入路。这项研究的目的是验证微创多端口方法的可行性，以获得先进的操作能力和视觉控制，并开发一个用于术前规划的软件工具。方法：研究方法。从20个常规的颞骨CT扫描中提取解剖的3D模型。使用专门设计的规划软件工具，模拟内耳道、圆窗和岩尖的无碰撞轨迹。颅底外科医生选择了一组三个无碰撞的轨迹，以最大化到关键结构的距离和轨迹之间的角度。结果。在不破坏关键解剖结构的情况下，可以成功地对每个颞骨模型中的三个目标进行三个无碰撞轨迹的模拟。结论。侧颅底微创多孔入路是可行的。所开发的软件是术前计划的第一步。进一步的研究将集中在身体和临床翻译上。
Objective. Minimally invasive procedures minimize iatrogenic tissue damage and lead to a lower complication rate and high patient satisfaction. To date only experimental minimally invasive single-port approaches to the lateral skull base have been attempted. The aim of this study was to verify the feasibility of a minimally invasive multiport approach for advanced manipulation capability and visual control and develop a software tool for preoperative planning. Methods. Anatomical 3D models were extracted from twenty regular temporal bone CT scans. Collision-free trajectories, targeting the internal auditory canal, round window, and petrous apex, were simulated with a specially designed planning software tool. A set of three collision-free trajectories was selected by skull base surgeons concerning the maximization of the distance to critical structures and the angles between the trajectories. Results. A set of three collision-free trajectories could be successfully simulated to the three targets in each temporal bone model without violating critical anatomical structures. Conclusion. A minimally invasive multiport approach to the lateral skull base is feasible. The developed software is the first step for preoperative planning. Further studies will focus on cadaveric and clinical translation.