Evaluation of nonlinear approaches and manipulation space

在项目的初始阶段（FOR 1585，多端口骨手术作为耳基MUKNO的例子），通过优化耳基内不同感兴趣区域的成像、配准和风险评估，开发了基于软件的多端口入路规划和模拟。这些结果可以在人体颞骨尸体模型的仿真传输中得到验证。然而，在石质骨的较深部分的通路的干扰，以及操作空间的设计，例如在微创切除肿瘤的情况下仍然存在问题。通过非线性路径，可以绕过关键区域，以最短的路径到达感兴趣的区域，有望向前迈出重要的一步。非线性钻井轨迹的应用也允许与线性方法相结合，因为可能有更大的直径。它必须对耳基的非线性访问进行可行性分析。这必须是对这种新方法的潜在新迹象、应用范围和安全方面的评价，必须与以前的方法以及MUKNO在第一个供资期间的调查结果进行比较。此外，我们必须用最大的操作室来定义目标区域。这应该根据目前可用的仪器以及未来的执行器来完成。为了开发和规划必要的体积和颞骨内目的地的可用性，创建了骨骼的解剖空间使用分析，作为对现有地图集知识的补充。待开发的非线性钻井系统需要将第一期开发的钻井平台与定位单元进行改造。这些应该在进一步的工作包中改变，它可以用于线性、常规钻井系统，也可以用于非线性钻井系统，因为非线性和线性钻井轨迹的同步应用也应该安排好。术中完成钻孔作业后，作为内窥镜固定系统使用。在颞骨研究的基础上，新的微创外科解剖图谱知识也必须进行评估，因为已知的探查手术的外科标志不再适用于新的内窥镜入路。这也应该解决现代内窥镜技术的各个方面，包括3d切片和缝合全景图像创建，包括“看墙后”或“立体视图”。

In the initial phase of the project (FOR 1585, multi-port bone surgery as example of the otobasis MUKNO) a software-based planning and simulation of the multi-port approaches was developed by optimization of imaging, registration and risk assessment to different regions of interest within the otobasis. These results could be validated in the transmission of the simulation on a human temporal bone cadaver model. However, an interference of the access routes in deeper parts of the petrous bone, as well as the design of the manipulation space, e.g. in case of a minimally invasive resection of tumors remain problematic. A significant step forward is expected through non-linear pathways which could bypass critical regions in accordance with shortest access to the region of interest. The application of non-linear trajectory of drilling allows also a combination with linear approaches as probably larger diameters are possible.It has to perform a feasibility analysis for non-linear access to the otobasis. This must be an evaluation of the potential new indications, the range of applications as well as security aspects of this new approach which has to be compared with previous methods, as well as with the findings of MUKNO from the first funding period. Furthermore, we have to define the target area with a maximum manipulation room. This should be done in terms of currently available instruments as well as future actuators. For the development and planning of the necessary volume and availability of destinations within the temporal bone, an anatomical space usage analysis of the bone is created as a supplement to the existing knowledge of the atlases. The non-linear system of drilling to be developed requires a modification of the drilling platform developed in the first period with the positioning unit. These should be altered in a further work package, that it can be used for linear, conventional drilling systems, as well as for the non-linear system of the drilling, because also the synchronous application of non-linear and linear trajectories of drilling should be scheduled. Also the platform should be used intraoperatively after completing drilling work as endoscope holding system. On the basis of temporal bone studies, a new minimally invasive surgical anatomical atlas-knowledge must be evaluated also because known surgical landmarks of exploratory surgery are no longer valid for the new endoscopic approaches. This should also address aspects of modern endoscopic techniques including 3DSlicing and stiching with panoramic image creation and included "look behind the wall" or "cubism view".