Minimally invasive, multi-port approach to the lateral skull base: a first in vitro evaluation
Minimally invasive, multi-port approach to the lateral skull base: a first in vitro evaluation
复制标题
侧颅底微创多孔入路：首次体外评估
DOI：
10.1007/s11548-017-1533-5
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发表时间：
2017
影响因子：
3
通讯作者：
Schipper J
中科院分区：
文献类型：
--
作者：
Stenin I;Hansen S;Nau-Hermes M;El-Hakimi W;Becker M;Bredemann J;Kristin J;Klenzner T;Schipper J
目的：本研究的目的是在尸体标本上验证一种微创、多通道的内耳道侧颅底入路。方法将基准和定制底板固定在尸体颅骨上，获取计算机断层图像。从乳突表面到内耳道的三条轨迹用定制的规划工具计算。在底板上安装了自主开发的带导向钻的定位系统。在高精度三坐标测量机上参考后，根据规划的轨迹对准钻头导轨。用医用不锈钢钻头钻取三个轨迹。结果利用所提出的工作流程和工具，成功地规划和钻取了三条内耳道轨迹。该系统的平均钻孔误差（计划轨迹与实际钻孔管道中心线之间的欧几里德距离）在入口点为mm，在目标点为mm。钻削过程本身的不准确性及其物理限制被认为是主要的影响因素。结论该系统可在侧颅底规划和钻孔多个微创管。需要进一步的研究来减少钻孔误差，并评估该系统的临床应用。
PurposeThe aim of the study was to validate a minimally invasive, multi-port approach to the internal auditory canal at the lateral skull base on a cadaver specimen.MethodsFiducials and a custom baseplate were fixed on a cadaver skull, and a computed tomography image was acquired. Three trajectories from the mastoid surface to the internal auditory canal were computed with a custom planning tool. A self-developed positioning system with a drill guide was attached to the baseplate. After referencing on a high precision coordinate measuring machine, the drill guide was aligned according to the planned trajectories. Drilling of three trajectories was performed with a medical stainless steel drill bit.ResultsThe process of planning and drilling three trajectories to the internal auditory canal with the presented workflow and tools was successful. The mean drilling error of the system (Euclidian distance between the planned trajectory and centerline of the actual drilled canal) wasmm at the entry point andmm at the target. The inaccuracy of the drill process itself and its physical limitations were identified as the main contributing factors.ConclusionThe presented system allows the planning and drilling of multiple minimally invasive canals at the lateral skull base. Further studies are required to reduce the drilling error and evaluate the clinical application of the system.
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