Image-guided placement of the Bonebridge without surgical navigation equipment
Image-guided placement of the Bonebridge without surgical navigation equipment
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DOI：
10.1007/s11548-013-0973-9
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发表时间：
2014-09-01
影响因子：
3
通讯作者：
Hashizume, Makoto
中科院分区：
文献类型：
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作者：
Cho, Byunghyun;Matsumoto, Nozomu;Hashizume, Makoto
目前大多数骨桥手术都是在计算机上进行术前模拟计划的。然而，外科医生通常使用骨表面的地标来确定植入设备的位置，仅使用计算机中的模拟图像作为参考（传统方法）。我们开发了一种图像引导方法来精确复制骨桥植入时的模拟手术。基于我们之前开发的用于图像引导耳科手术的表面模板辅助标记定位（STAMP）方法，我们制作了仅适合患者颞骨表面指定位置的模板。Bonebridge STAMP （BB-STAMP）板显示开始钻孔的确切位置。BB-STAMP还与射孔导向滑套相结合，因此可以精确地复制模拟的圆柱形井的位置、方向和深度。我们还创建了一个STAMP板，以确认只有在正确的位置完成充分的钻孔后才适合。为了评估所提出的方法，我们对4块尸体颞骨及其12块复制品进行了模拟手术（4块骨头各3块）。比较了模拟位置与实际位置之间的时间和不匹配程度。将提出的BB-STAMP方法与常规方法进行了可行性研究。虽然使用BB-STAMP和穿支引导器总是更快，但手术所需的时间在手术方法之间没有显着差异。当手术由BB-STAMP带或不带穿支引导时，模拟模型与切除模型之间的不匹配程度倾向于较小，尽管差异无统计学意义。提出的BB-STAMP是一种很有前途的方法，可以在不使用外科导航系统的情况下精确复制模拟过程中的操作。
Most of the current Bonebridge surgeries undergo preoperative simulation planning in a computer. However, surgeons usually use the landmarks on the bone surface to determine the location where to implant the device, using the simulation image in the computer only as a reference (conventional method). We developed an image-guided method for precisely replicating simulation surgery upon performing Bonebridge implantation.Based on our previous development of the surface template-assisted marker positioning (STAMP) method for performing image-guided otologic surgery, we fabricated templates that fit only at the designated location on the patient's temporal bone surface. The Bonebridge STAMP (BB-STAMP) plate shows the exact location where to start drilling. The BB-STAMP was also combined with a perforator-guiding sleeve, so that the location, direction and depth of the cylindrical well could be precisely replicated as simulated. We also created a STAMP plate for confirmation that fits only after sufficient drilling at the correct location is finished. To evaluate the proposed methods, we performed simulation surgery on four cadaveric temporal bones and their 12 replicas (three each for four bones). The time used and the degree of mismatch between the simulated location and the drilled location were compared.A feasibility study was successfully conducted using the proposed BB-STAMP methods and the conventional method. The amount of time required for the procedure did not differ significantly between the surgical methods, although using the BB-STAMP and perforator guide was always quicker. The degree of mismatch between the simulation and resected models had tendency to be smaller when the surgery was guided by the BB-STAMP with or without a perforator guide, although the difference was not statistically significant.The proposed BB-STAMP is a promising method for replicating exactly what is performed during simulation without using a surgical navigation system.