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Augmented reality for endoscopic sinus surgery with surgical navigation: a cadaver study
Author(s) -
Citardi Martin J.,
Agbetoba Abib,
Bigcas JoLawrence,
Luong Amber
Publication year - 2016
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21702
Subject(s) - medicine , dissection (medical) , cadaver , internal carotid artery , cadaveric spasm , surgical planning , optic nerve , navigation system , radiology , surgery , computer vision , anatomy , computer science
Background Augmented reality (AR) fuses computer‐generated images of preoperative imaging data with real‐time views of the surgical field. Scopis Hybrid Navigation (Scopis GmbH, Berlin, Germany) is a surgical navigation system with AR capabilities for endoscopic sinus surgery (ESS). Methods Predissection planning was performed with Scopis Hybrid Navigation software followed by ESS dissection on 2 human specimens using conventional ESS instruments. Results Predissection planning included creating models of relevant frontal recess structures and the frontal sinus outflow pathway on orthogonal computed tomography (CT) images. Positions of the optic nerve and internal carotid artery were marked on the CT images. Models and annotations were displayed as an overlay on the endoscopic images during the dissection, which was performed with electromagnetic surgical navigation. The accuracy of the AR images relative to underlying anatomy was better than 1.5 mm. The software's trajectory targeting tool was used to guide instrument placement along the frontal sinus outflow pathway. AR imaging of the optic nerve and internal carotid artery served to mark the positions of these structures during the dissection. Conclusion Surgical navigation with AR was easily deployed in this cadaveric model of ESS. This technology builds upon the positive impact of surgical navigation during ESS, particularly during frontal recess surgery. Instrument tracking with this technology facilitates identifying and cannulation of the frontal sinus outflow pathway without dissection of the frontal recess anatomy. AR can also highlight “anti‐targets” (ie, structures to be avoided), such as the optic nerve and internal carotid artery, and thus reduce surgical complications and morbidity.