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Validation of a rhinologic virtual surgical simulator for performing a Draf 3 endoscopic frontal sinusotomy
Author(s) -
Won TaeBin,
Cho SungWoo,
Sung MyungWhun,
Paek Sun Ha,
Chan Sonny,
Salisbury Kenneth,
Blevins Nikolas H.,
Vaisbuch Yona,
Hwang Peter
Publication year - 2019
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.22333
Subject(s) - medicine , cadaver , coronal plane , dissection (medical) , nuclear medicine , interquartile range , radiology , anatomy , surgery
Background We recently introduced a patient‐specific rhinologic virtual surgical environment (VSE) that has shown potential for surgical rehearsal of various skull base lesions. Our aim in this study was to validate the usefulness of the rhinology VSE in performing the Draf 3 procedure. Methods An outside‐in Draf 3 procedure was performed on 4 cadaver heads. Computed tomography (CT) scans were obtained before and after cadaver dissection (CD). Pre‐dissection CT scans were used to construct a cadaver‐specific VSE. A virtual Draf 3 dissection (VD) was performed using the same technique. Validation was conducted by comparing the final common frontal outflow tract. A subjective comparison of the post‐dissection endoscopic findings (CD vs VD) and an objective measurement using the post‐dissection CT scan for the CD and the reconstructed CT scan obtained from the data after the VD was performed. Results Subjective overall resemblance of the 2 dissections (CD vs VD) assessed by the 4‐point Likert scale (0‐3) was 2.5 (median interquartile range [IQR], 0.25) for the 4 cadavers. The median difference for the anteroposterior dimension of the frontal neo‐ostium (CD vs VD) assessed in the midsagittal view was 0.11 mm, whereas the median difference for the lateral dimension assessed in the coronal view was 2.71 mm. Thus, no statistical difference was observed. Conclusion VD showed nearly matching results with the actual cadaver dissection. With further validation, our rhinologic VSE may be used for presurgical planning and rehearsal before the actual Draf 3 procedure is performed in the operating room.