Joseph A Paydarfar1,2, Xiaotian Wu2, Ryan J Halter2,3. 1. Section of Otolaryngology, Audiology, and Maxillofacial Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Lebanon, New Hampshire. 2. Thayer School of Engineering at Dartmouth, Hanover, New Hampshire. 3. Dartmouth College Geisel School of Medicine, Department of Surgery, Hanover, New Hampshire.
Abstract
BACKGROUND: Surgical navigation using image guidance may improve the safety and efficacy of transoral surgery (TOS); however, preoperative imaging cannot be accurately registered to the intraoperative state due to deformations resulting from placement of the laryngoscope or retractor. This proof of concept study explores feasibility and registration accuracy of surgical navigation for TOS by utilizing intraoperative imaging. METHODS: Four patients undergoing TOS were recruited. Suspension laryngoscopy was performed with a CT-compatible laryngoscope. An intraoperative contrast enhanced CT scan was obtained and registered to fiducials placed on the neck, face, and laryngoscope. RESULTS: All patients were successfully scanned and registered. Registration accuracy within the pharynx and larynx was 1 mm or less. Target registration was confirmed by localizing endoscopic and surface structures to the CT images. Successful tracking was performed in all 4 patients. CONCLUSION: For surgical navigation during TOS, although a high level of registration accuracy can be achieved by utilizing intraoperative imaging, significant limitations of the existing technology have been identified. These limitations, as well as areas for future investigation, are discussed.
BACKGROUND: Surgical navigation using image guidance may improve the safety and efficacy of transoral surgery (TOS); however, preoperative imaging cannot be accurately registered to the intraoperative state due to deformations resulting from placement of the laryngoscope or retractor. This proof of concept study explores feasibility and registration accuracy of surgical navigation for TOS by utilizing intraoperative imaging. METHODS: Four patients undergoing TOS were recruited. Suspension laryngoscopy was performed with a CT-compatible laryngoscope. An intraoperative contrast enhanced CT scan was obtained and registered to fiducials placed on the neck, face, and laryngoscope. RESULTS: All patients were successfully scanned and registered. Registration accuracy within the pharynx and larynx was 1 mm or less. Target registration was confirmed by localizing endoscopic and surface structures to the CT images. Successful tracking was performed in all 4 patients. CONCLUSION: For surgical navigation during TOS, although a high level of registration accuracy can be achieved by utilizing intraoperative imaging, significant limitations of the existing technology have been identified. These limitations, as well as areas for future investigation, are discussed.
Authors: Bruce H Haughey; Michael L Hinni; John R Salassa; Richard E Hayden; David G Grant; Jason T Rich; Simon Milov; James S Lewis; Murli Krishna Journal: Head Neck Date: 2011-01-31 Impact factor: 3.147
Authors: Andrew K Ma; Michael Daly; Jimmy Qiu; Harley H L Chan; David P Goldstein; Jonathan C Irish; John R de Almeida Journal: Head Neck Date: 2017-07-28 Impact factor: 3.147
Authors: S Reaungamornrat; W P Liu; A S Wang; Y Otake; S Nithiananthan; A Uneri; S Schafer; E Tryggestad; J Richmon; J M Sorger; J H Siewerdsen; R H Taylor Journal: Phys Med Biol Date: 2013-06-27 Impact factor: 3.609
Authors: N Haberland; K Ebmeier; R Hliscs; J P Grnewald; J Silbermann; J Steenbeck; H Nowak; R Kalff Journal: J Cancer Res Clin Oncol Date: 2000-09 Impact factor: 4.553
Authors: C E Williams; A J Kinshuck; S G Derbyshire; N Upile; S Tandon; N J Roland; S R Jackson; J Rodrigues; D J Husband; J L Lancaster; T M Jones Journal: Eur Arch Otorhinolaryngol Date: 2013-05-04 Impact factor: 2.503
Authors: Carolina Blanco-Angulo; Andrea Martínez-Lozano; Carlos G Juan; Roberto Gutiérrez-Mazón; Julia Arias-Rodríguez; Ernesto Ávila-Navarro; José M Sabater-Navarro Journal: Sensors (Basel) Date: 2022-05-19 Impact factor: 3.847