Mastoidectomy Simulator for Surgical Training and Rehearsal

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Mastoidectomy is a complex surgical procedure in which portions of the skull are drilled away**to treat ear infections, to place cochlear implants and to remove tumours. Hundreds of**thousands of mastoidectomies are performed worldwide each year with surgical complication**rates as high as 20%. Surgical mistakes are disastrous and include facial nerve paralysis,**hearing loss, tinnitus, vertigo and altered taste. Significant training is required to master the**procedure. However, training is hampered by a shortage of cadaveric materials. To provide**an alternative training approach, we have developed a virtual-reality simulator that allows the**user to operate on a single 3D digital head model. Practice on a single model does not**prepare trainees for the large variability in patient anatomy, but creating additional models is**difficult. Moreover, careful evaluation of the simulator is required for acceptance.**Our objectives are to (1) develop software to automatically construct digital models from**patient images, (2) implement automated performance assessment methods, and (3)**evaluate skill development and transfer from the virtual environment to realistic settings.**We will develop software to automatically warp a template digital anatomical model to match**a specific patient image, thus generating models for new patients. We will implement**software that automates evaluation of each trainees performance when operating on virtual**head models. The software will be based on well validated metrics that are used in current**practice by instructors. To evaluate skill development and transfer, an expert panel of**Otolaryngologists will evaluate trainees on cadaveric skulls before and after training using the**simulator.**The simulator will result in increased and improved training opportunities on a wide variety of**patient types. Moreover, it will allow rehearsal on a digital model prior to surgery on a specific**anatomy, leading to improved surgical performance.