Computer-assisted neurosurgery by using a noninvasive vacuum-affixed dental cast that acts as a reference base: another step toward a unified approach in the treatment of brain tumors

Bale, Reto; Burtscher, Johannes; Eisner, Wilhelm; Obwegeser, Alois Albert; Rieger, Michael; Sweeney, Reinhart A.; Dessl, A.; Giacomuzzi, Salvatore; Twerdy, K; Jaschke, Werner

doi:10.3171/jns.2000.93.2.0208

Cited by 48 publications

(52 citation statements)

References 17 publications

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“…Other groups have also reported registration errors based on bite-blocks that mount to the patient's maxillary dentition [4,10,11], but none of them has employed theoretical calculations to determine the contribution to error caused by the error in the application of the bite block.…”

Section: Discussionmentioning

confidence: 99%

Bite-Block Relocation Error in Image-Guided Otologic Surgery

Fitzpatrick

Balachandran

Labadie

2004

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2004

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Abstract. Otologic surgery is undertaken to treat ailments of the ear including persistent infections, hearing loss, vertigo, and cancer. Typically performed on healthy patients in outpatient facilities, the application of image-guided surgery has been limited because accurate (<1mm), non-invasive fiducial systems for otologic surgery are not available. We have developed such a system, which repeatably attaches to a subject via a dental bite block [1]. In a previous report, ex-vivo validation indicated that mean target registration error ± standard deviation for 234 targets within the surgical field was 0.73±0.23mm with a root mean square of 0.77mm [2,3]. In an effort to further understand the limitations of our system, we undertook, and report herein, a detailed error analysis to determine what portion of the error is attributable to the inaccuracies in relocation fit of the fiducial frame to a subject's dentition. Our analysis shows that the root-mean-square error due to relocation alone is approximately 0.66 mm, while that due to fiducial registration is approximately 0.30 mm.

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Section: Discussionmentioning

confidence: 99%

Bite-Block Relocation Error in Image-Guided Otologic Surgery

Fitzpatrick

Balachandran

Labadie

2004

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2004

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“…Although the more distant targets yielded slightly larger values, confirming the significant impact of the distance between the registration and target points on the accuracy [7,8,21], even the maximum deviation of 1.2 mm is still within the range (1 to 2 mm) that is often considered ''clinically acceptable'' for navigation system accuracy [1,21,25,26]. Maxillary splint-based systems with extraoral extensions for reference markers have been used previously with sufficient navigational accuracy in neurosurgery (0.29-0.86 mm [17], 0.0-2.0 mm [27]), in sinus surgery (1.56 AE 0.76 mm [28]), and in the temporal region (0.73 AE 0.25 mm [17,29]); however, only a few of these systems have been tested for targets in the lateral skull base region [15,29,30,31]. Bale et al used a mouthpiecebased registration template held in place by a vacuum system to successfully cannulate the foramen ovale [30], but did not test its applicability for Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Image guided surgery of the lateral skull base: Testing a new dental splint registration device

Ledderose

Hagedorn

Spiegl

et al. 2011

Computer Aided Surgery

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Objective: The widespread use of image guided surgery in the frontolateral skull base region has been limited by the need for a reliable and non-invasive registration procedure that provides sub-millimetric accuracy. We developed and validated preclinically a non-invasive, easy-to-use registration device based on a dental splint with a laterally mounted fiducial carrier. Methods: Repeated accuracy measurements were performed on six titanium target fiducials which were screwed into the lateral skull base region of a cadaver head and could be unequivocally identified both on the CT image and in reality. The system accuracy was evaluated by determining the deviation of the real target position from the position indicated in the CT scan. The accuracy of the dental splint-based registration was compared to that of two standard registration procedures: contour-based laser surface registration and fixed marker registration. Results: The mean accuracy of 0.55 AE 0.28 mm obtained when using the maxillary splint device was similar to that obtained with the ''gold standard'' registration using bone-implanted markers (0.33 AE 0.26 mm), while being clearly superior to that obtained with contour-based laser surface registration (1.91 AE 0.74 mm). Conclusions: Registration using the non-invasively fixed maxillary fiducial platform can provide sub-millimetric accuracy in the lateral skull base region. In vivo validation may prove dental splint-based registration to be an accurate and non-invasive alternative option for image guided surgery of the lateral skull base, and may facilitate the application of navigation systems in this delicate region.

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“…This is especially helpful for placement of the distal part of the catheter. Different techniques for fixation of a DRF have been reported, including a vacuum-affixed dental cast [14,17] . Although good results for navigation in intracranial procedures and temporal bone surgery have been reported using a DRF fixed to the maxilla, we think that for shunt surgery this technique is better suited.…”

Section: Discussionmentioning

confidence: 99%

“…A technique to monitor and calculate this relative motion, referred to as dynamic reference frame (DRF), has been introduced. A DRF works by continuous tracking of a device fixed to the skull with optoelectric or electromagnetic techniques [6,14,15] . The potential benefit for ventricular catheterization would be the opportunity to move the patient's head during surgery, as it is often necessary for placement of the distal part of the catheter in shunt surgery.…”

Section: Placement Of Intraventricular Catheters Usingmentioning

confidence: 99%

Placement of Intraventricular Catheters Using Flexible Electromagnetic Navigation and a Dynamic Reference Frame: A New Technique

Rodt

Köppen

Lorenz

et al. 2007

Stereotact Funct Neurosurg

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Background: Catheterization of narrow ventricles may prove difficult resulting in misplacement or inefficient trials with potential damage to brain tissue. Material and Methods: The application of a new module for navigated ventricular catheterization using flexible electromagnetic navigation and a dynamic reference frame is presented. Results: Navigated catheter placement was successful and accurate in a pilot study. Electromagnetic interferences had to be taken into consideration. Conclusion: Flexible electromagnetic navigation with a dynamic reference frame is a useful tool for catheter placement as it reduces the risk of misplacement or repeated catheterization trials.

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Computer-assisted neurosurgery by using a noninvasive vacuum-affixed dental cast that acts as a reference base: another step toward a unified approach in the treatment of brain tumors

Abstract: Because of its noninvasive, rigid, reliable, and reproducible connection to the patient's head, the VBH vacuum-affixed mouthpiece grants the registration device an accuracy comparable to invasive fiducial markers.

Cited by 48 publications

References 17 publications

Bite-Block Relocation Error in Image-Guided Otologic Surgery

Bite-Block Relocation Error in Image-Guided Otologic Surgery

Image guided surgery of the lateral skull base: Testing a new dental splint registration device

Placement of Intraventricular Catheters Using Flexible Electromagnetic Navigation and a Dynamic Reference Frame: A New Technique

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