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Initial experience with image‐guided surgical navigation in transoral surgery
Author(s) -
Paydarfar Joseph A.,
Wu Xiaotian,
Halter Ryan J.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25380
Subject(s) - medicine , fiducial marker , retractor , image guided surgery , transoral robotic surgery , larynx , laryngoscopy , radiology , image registration , surgery , computer vision , intubation , computer science , image (mathematics)
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.