Endoscopic nasal sinus surgery simulator to optimize treatment outcome

内窥镜鼻窦手术模拟器可优化治疗效果

• 批准号: 9884609
• 负责人: KAI ZHAO
• 金额: $ 19.69万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-05 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9884609
• 关键词: 3-Dimensional; Adult; Advanced Development; Affect; Aftercare; Air; Air Movements; Anatomy; Blinded; Clinical; Complex; Computers; Databases; Detection; Devices; Disease; Disease Management; Double-Blind Method; Drops; Endoscopy; Engineering; Enrollment; Etiology; Excision; Feedback; Fossa; Future; Hypertrophy; Intervention Studies; Lead; Liquid substance; Medical; Modeling; Nasal Polyps; Nasal turbinate bone structure; Nose; Obstruction; Odors; Operative Surgical Procedures; Outcome; Pathology; Patients; Polyps; Positioning Attribute; Preparation; Process; Research; Resistance; Scientist; Series; Sinus; Site; Smell Perception; Subgroup; Surgeon; Surgical Instruments; Symptoms; System; Tactile; Testing; Time; Tissues; Treatment outcome; Validation; Visual; Visualization; X-Ray Computed Tomography; base; clinical care; clinical practice; computer science; design; functional improvement; functional outcomes; haptics; image guided; image processing; improved; improved outcome; innovation; multidisciplinary; nasal obstruction; particle; personalized medicine; preservation; pressure; prospective; prototype; shear stress; surgery outcome; tool; treatment optimization; virtual; virtual reality; virtual reality system; virtual surgery

Project Summary Millions of endoscopic nasal sinus surgeries are performed annually worldwide, yet the outcomes are often variable. One reason is that predicting functional outcomes (e.g. nasal airflow) based solely on CT or endoscopy can be difficult. The lack of an objective planning system results in ineffective disease management. For this proposal, a unique multidisciplinary team of clinicians, computer scientists, and engineers was assembled to develop a virtual endoscopic sinus surgery simulator that would simulate patient anatomy, reveal flow obstructions, and ultimately facilitate optimization of the outcome of surgical approaches for treatment of nasal obstruction and conductive olfactory loss. Using virtual reality, the surgeon can remove obstructive tissue virtually through a haptic (tactile and kinesthetic) feedback device. After each virtual surgery, changes in nasal airflow can be computed and displayed and the process reiterated until an optimal result is reached. A trial using this approach was performed on four patients as a proof of concept, and a normative range of air/odor flow based on 22 healthy controls was established. We will continue to improve the overall fidelity of our system (Aim 1) by incorporating feedback from clinicians and iterative innovation employing recent advances in computer science (image processing, volume visualization, haptic modeling, interface design). We will also perform non-interventional trials on 20 patients and focus on nasal obstruction related olfactory loss (Aim 2) and test the hypothesis that the virtual sinus surgery simulator can improve treatment outcomes to conductive olfactory loss. While this proposal is limited to the specific symptom of obstruction-related olfactory loss, but in the future the tool can be expanded to improve outcomes for more generalized nasal obstruction symptoms. Ultimately, developing and validating such a virtual surgical planning system will prove invaluable for future surgical treatment of nasal obstruction and has the potential to directly improve clinical practice and offer personalized medicine.

项目摘要 每年在全球范围内进行数百万个内窥镜鼻窦手术，但结果是 通常可变。原因之一是仅基于CT或 内窥镜检查可能很困难。缺乏客观计划系统导致疾病管理无效。 对于此建议，一个独特的跨学科团队由临床医生，计算机科学家和工程师组成 组装以开发虚拟内窥镜鼻窦手术模拟器，该模拟器将模拟患者解剖学，揭示 流动障碍，并最终促进了治疗外科手术方法结果的优化 鼻阻塞和导电嗅觉损失。使用虚拟现实，外科医生可以去除阻塞组织 实际上，通过触觉（触觉和动力学）反馈设备。每次虚拟手术后，鼻腔变化 可以计算和显示气流，并重申该过程，直到达到最佳结果为止。试验 使用这种方法是对四名患者进行的概念证明，并且空气/气味的规范范围 建立了基于22个健康对照的流量。 我们将通过合并来自 临床医生和迭代创新采用了计算机科学的最新进展（图像处理，音量 可视化，触觉建模，界面设计）。我们还将对20名患者进行非介入试验 并专注于鼻阻塞相关的嗅觉损失（AIM 2），并检验了虚拟窦的假设 手术模拟器可以改善治疗结果，从而使导电性嗅觉损失。虽然该提议仅限于 与阻塞有关的嗅觉损失的特定症状，但将来可以扩展工具以改进 更广泛的鼻阻塞症状的结果。 最终，制定和验证这种虚拟手术计划系统将证明是无价的 未来对鼻阻塞的手术治疗，有可能直接改善临床实践并提供 个性化医学。