Mastoidectomy Simulator for Surgical Training and Rehearsal

乳突切除术是一种复杂的外科手术，其中部分颅骨被钻掉 ** 以治疗耳部感染，放置耳蜗植入物和切除肿瘤。全世界每年进行数十万例乳突切除术，手术并发症 ** 率高达20%。手术失误是灾难性的，包括面部神经麻痹，听力损失，耳鸣，眩晕和味觉改变。掌握 ** 程序需要大量培训。然而，由于缺乏尸体材料，培训受到阻碍。为了提供一种替代的训练方法，我们开发了一种虚拟现实模拟器，允许用户在单个3D数字头部模型上操作。在单个模型上进行练习并不能使受训者为患者解剖结构的巨大变化做好准备，但是创建额外的模型是困难的。此外，还需要对模拟器进行仔细评估，以便进行验收。**我们的目标是（1）开发软件，从 ** 患者图像自动构建数字模型，（2）实施自动化性能评估方法，（3）** 评估技能发展并从虚拟环境转移到现实环境。我们将开发软件，自动扭曲模板数字解剖模型，以匹配 ** 一个特定的患者图像，从而为新患者生成模型。我们将实施 ** 软件，在虚拟 ** 头部模型上操作时，自动评估每个受训者的表现。该软件将基于教师在当前 ** 实践中使用的经过充分验证的指标。为了评估技能的发展和转移，** 耳鼻喉科专家小组将使用 ** 模拟器在训练前后对尸体头骨上的受训者进行评估。**模拟器将增加和改善各种 ** 患者类型的培训机会。此外，它将允许在对特定解剖结构进行手术之前在数字模型上进行排练，从而提高手术性能。

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.