Evaluation of nonlinear approaches and manipulation space

在项目的初始阶段(以1585年为例，多端口骨科手术为OtoBasis MUKNO)，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方法的规划和模拟。这些结果可以在一个人的颞骨身体模型上的仿真传输中得到验证。然而，岩骨更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。预计将通过可绕过关键区域的非线性路径向前迈出重要的一步，根据对感兴趣区域的最短通道。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。必须对非线性进入耳基进行可行性分析。这必须是对这一新方法的潜在新适应症、适用范围以及安全方面的评估，必须与以前的方法以及MUKNO从第一个资助期开始的调查结果进行比较。此外，我们必须定义具有最大操纵空间的目标区域。这应该根据目前可用的仪器以及未来的执行器来完成。为了开发和规划颞骨内必要的体积和目的地的可用性，创建了对骨骼的解剖空间使用分析，作为对现有地图集知识的补充。要开发的钻井非线性系统需要对第一阶段开发的带有定位单元的钻井平台进行改进。这些应在进一步的一揽子工作中加以修改，以便可用于线性、常规钻井系统以及钻井的非线性系统，因为还应安排同步应用钻井的非线性和线性轨迹。完成钻孔作业后，应在术中使用该平台作为内窥镜支撑系统。在颞骨研究的基础上，还必须评估新的微创外科解剖图谱知识，因为已知的探查手术的外科标志不再适用于新的内窥镜手术入路。这也应该涉及现代内窥镜技术的各个方面，包括3D拼接和拼接与全景图像创建，并包括“墙后看”或“立体主义观点”。

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".