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Rigshospitalet - a part of Copenhagen University Hospital
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Patient-specific Virtual Temporal Bone Simulation Based on Clinical Cone-beam Computed Tomography

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OBJECTIVES: Patient-specific surgical simulation allows presurgical planning through three-dimensional (3D) visualization and virtual rehearsal. Virtual reality simulation for otologic surgery can be based on high-resolution cone-beam computed tomography (CBCT). This study aimed to evaluate clinicians' experience with patient-specific simulation of mastoid surgery.

METHODS: Prospective, multi-institutional study. Preoperative temporal bone CBCT scans of patients undergoing cochlear implantation (CI) were retrospectively obtained. Automated processing and segmentation routines were used. Otologic surgeons performed a complete mastoidectomy with facial recess approach on the patient-specific virtual cases in the institution's temporal bone simulator. Participants completed surveys regarding the perceived accuracy and utility of the simulation.

RESULTS: Twenty-two clinical CBCTs were obtained. Four attending otologic surgeons and 5 otolaryngology trainees enrolled in the study. The mean number of simulations completed by each participant was 16.5 (range 3-22). "Overall experience" and "usefulness for presurgical planning" were rated as "good," "very good," or "excellent" in 84.6% and 71.6% of the simulations, respectively. In 10.7% of simulations, the surgeon reported to have gained a significantly greater understanding of the patient's anatomy compared to standard imaging. Participants were able to better appreciate subtle anatomic findings after using the simulator for 60.4% of cases. Variable CBCT acquisition quality was the most reported limitation.

CONCLUSION: Patient-specific simulation using preoperative CBCT is feasible and may provide valuable insights prior to otologic surgery. Establishing a CBCT acquisition protocol that allows for consistent segmentation will be essential for reliable surgical simulation.

LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1855-1862, 2021.

Original languageEnglish
JournalThe Laryngoscope
Volume131
Issue number8
Pages (from-to)1855-1862
Number of pages8
ISSN0023-852X
DOIs
Publication statusPublished - Aug 2021

    Research areas

  • Adult, Cochlear Implantation/education, Cone-Beam Computed Tomography/methods, Feasibility Studies, Female, Humans, Imaging, Three-Dimensional, Male, Mastoidectomy/education, Middle Aged, Otolaryngology/education, Patient-Specific Modeling, Prospective Studies, Temporal Bone/diagnostic imaging, Virtual Reality, Young Adult, virtual reality surgical simulation, presurgical planning, Temporal bone anatomy, otology, patient-specific rehearsal, segmentation

ID: 66965344