Feasibility Assessment of Optical Coherence Tomography-Guided Laser Labeling in Middle Cranial Fossa Approach

verfasst von

Saleh Mohebbi, Jakob Lexow, Alexander Fuchs, Thomas Rau, Sebastian Tauscher, Marjan Mirsalehi, Seyed Mousa Sadr Hosseini, Tobias Ortmaier, Thomas Lenarz, Omid Majdani

Abstract

Introduction: Different approaches have been developed to find the position of the internal auditory canal (IAC) in middle cranial fossa approach. A feasibility study was performed to investigate the combination of cone beam computed tomography (CBCT), optical coherence tomography (OCT), and laser ablation to assist a surgeon in a middle cranial fossa approach by outlining the internal auditory canal (IAC). Materials and Methods: A combined OCT laser setup was used to outline the position of IAC on the surface of the petrous bone in cadaveric semi-heads. The position of the hidden structures, such as IAC, was determined in MATLAB software using an intraoperative CBCT scan. Four titanium spheres attached to the edge of the craniotomy served as reference markers visible in both CBCT and OCT images in order to transfer the plan to the patient. The integrated erbium-doped yttrium aluminum garnet laser was used to mark the surface of the bone by shallow ablation under OCT-based navigation before the surgeon continued the operation. Result: The technical setup was feasible, and the laser marking of the border of the IAC was performed with an overall accuracy of 300 μm. The depth of each ablation phase was 300 μm. The marks indicating a safe path supported the surgeon in the surgery. Conclusion: The technique investigated in the present study could decrease the surgical risks for the mentioned structures and improve the pace and precision of operation.

Organisationseinheit(en)

Institut für Mechatronische Systeme

Externe Organisation(en)

Medizinische Hochschule Hannover (MHH)
Tehran University of Medical Sciences
Iran University of Medical Sciences

Typ

Artikel

Journal

Iranian Journal of Otorhinolaryngology

Band

30

Seiten

321-327

Anzahl der Seiten

7

ISSN

2251-7251

Publikationsdatum

11.2018

Publikationsstatus

Veröffentlicht

Peer-reviewed

Ja

ASJC Scopus Sachgebiete

Hals-Nasen-Ohrenheilkunde

Elektronische Version(en)

https://doi.org/10.22038/ijorl.2018.30275.1991 (Zugang: Offen)