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Patient‐specific Virtual Temporal Bone Simulation Based on Clinical Cone‐beam Computed Tomography
Author(s) -
Andersen Steven Arild Wuyts,
Varadarajan Varun V.,
Moberly Aaron C.,
Hittle Bradley,
Powell Kimerly A.,
Wiet Gregory J.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29542
Subject(s) - otorhinolaryngology , medicine , cone beam computed tomography , temporal bone , medical physics , mastoidectomy , radiology , virtual reality , cochlear implantation , surgical planning , computed tomography , surgery , computer science , artificial intelligence , cholesteatoma , hearing loss , audiology
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