Endoscopic nasal sinus surgery simulator to optimize treatment outcome

项目摘要 全世界每年进行数百万次鼻内窥镜鼻窦手术，但结果是 通常是可变的。其中一个原因是，仅根据CT或 内窥镜检查可能会很困难。缺乏客观的规划体系，导致疾病管理不力。 对于这项提议，一个由临床医生、计算机科学家和工程师组成的独特的多学科团队 组装成一个虚拟的内窥镜鼻窦手术模拟器，它将模拟患者的解剖结构，揭示 血流障碍，并最终有助于优化手术方法的治疗结果 鼻塞和传导性嗅觉丧失。使用虚拟现实，外科医生可以移除梗阻组织 虚拟地通过触觉(触觉和动觉)反馈设备。每次虚拟手术后，鼻腔的变化 可以计算和显示气流，并重复该过程，直到达到最佳结果。一场审判 在四名患者身上使用这种方法作为概念验证，并确定了空气/气味的标准范围。 建立了以22名健康对照为基础的FLOW。 我们将继续通过吸收来自以下方面的反馈来提高我们系统的整体保真度(目标1) 临床医生和采用计算机科学(图像处理、体积)最新进展的迭代创新 可视化、触觉建模、界面设计)。我们还将对20名患者进行非干预性试验 并将重点放在鼻塞相关的嗅觉丧失(目标2)上，并测试虚拟鼻窦的假设 手术模拟器可以改善传导性嗅觉丧失的治疗结果。虽然这项提议仅限于 与阻塞相关的嗅觉丧失的具体症状，但在未来该工具可以扩展以改进 更普遍的鼻塞症状的结果。 最终，开发和验证这样的虚拟手术计划系统将被证明是非常有价值的 未来鼻塞的外科治疗，有可能直接改善临床实践，并提供 个性化医疗。

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.