Mixed reality temporal bone surgical dissector: mechanical design

Hochman, Jordan B.; Sepehri, Nariman; Rampersad, Vivek; Kraut, Jay; Khazraee, Milad; Pisa, Justyn; Unger, Bertram

doi:10.1186/s40463-014-0023-9

Cited by 15 publications

(12 citation statements)

References 6 publications

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“…Similarly, present findings revealed that despite partially realistic ergonomics and haptics, respondents would still value CardinalSim for preoperative planning, teaching, and resident assessment. Other research groups have argued for using 3D printed temporal bones over VR technology because of the presence of tactile feedback [13,27]. For instance, Hochman et al are developing a mixed reality dissection simulator citing enhanced haptic realism using 3D printed temporal bone specimens [27].…”

Section: Discussionmentioning

confidence: 99%

“…Other research groups have argued for using 3D printed temporal bones over VR technology because of the presence of tactile feedback [13,27]. For instance, Hochman et al are developing a mixed reality dissection simulator citing enhanced haptic realism using 3D printed temporal bone specimens [27]. Simulators that involve 3D printed technology do have an inherent advantage for haptic realism compared to VR platforms; however, these technologies are expensive and lack repeated dissection and real-time automated evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

Compton

Agrawal

Ladak

et al. 2020

J of Otolaryngol - Head & Neck Surg

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Background: Trainees in Otolaryngology-Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology. CardinalSim is a virtual reality temporal bone surgical simulator that offers a high-quality, inexpensive adjunct to traditional teaching methods. The objective of this study was to establish the face and content validity of CardinalSim through a national study. Methods: Otolaryngologists and resident trainees from across Canada were recruited to evaluate CardinalSim. Ethics approval and informed consent was obtained. A face and content validity questionnaire with questions categorized into 13 domains was distributed to participants following simulator use. Descriptive statistics were used to describe questionnaire results, and either Chi-square or Fishers exact tests were used to compare responses between junior residents, senior residents, and practising surgeons. Results: Sixty-two participants from thirteen different Otolaryngology-Head and Neck Surgery programs were included in the study (32 practicing surgeons; 30 resident trainees). Face validity was achieved for 5 out of 7 domains, while content validity was achieved for 5 out of 6 domains. Significant differences between groups (p-value of < 0.05) were found for one face validity domain (realistic ergonomics, p = 0.002) and two content validity domains (teaching drilling technique, p = 0.011 and overall teaching utility, p = 0.006). The assessment scores, global rating scores, and overall attitudes towards CardinalSim, were universally positive. Open-ended questions identified limitations of the simulator. Conclusion: CardinalSim met acceptable criteria for face and content validity. This temporal bone virtual reality surgical simulation platform may enhance surgical training and be suitable for patient-specific surgical rehearsal for practicing Otolaryngologists.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

Compton

Agrawal

Ladak

et al. 2020

J of Otolaryngol - Head & Neck Surg

View full text Add to dashboard Cite

show abstract

“…Issues in fidelity have still not been adequately resolved for simulations other than cadaveric temporal bone to be widely used in clinical training . The realism of VR simulators is still suboptimal despite advances in haptic feedback, and existing haptic simulations are unable to realistically reproduce the vibration and contact forces experienced during surgery . Additionally, VR simulations lack soft tissue and blood in dissection and cannot replicate the auditory feedback present during surgery .…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

“…The realism of VR simulators is still suboptimal despite advances in haptic feedback, and existing haptic simulations are unable to realistically reproduce the vibration and contact forces experienced during surgery . Additionally, VR simulations lack soft tissue and blood in dissection and cannot replicate the auditory feedback present during surgery . However, simulations developed for surgical rehearsal may have different fidelity requirements than those developed for surgical training .…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

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A review of simulation applications in temporal bone surgery

Kashikar

Kerwin

Moberly

et al. 2019

Laryngoscope Investig Oto

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Background Temporal bone surgery is a technically challenging and high‐risk procedure in an anatomically complex area. Safe temporal bone surgery emphasizes a consummate anatomic understanding and technique development that requires the guidance of an experienced otologic surgeon and years of practice. Temporal bone simulation can augment otologic surgical training and enable rehearsal of surgical procedures. Objectives The purpose of this article is to provide an updated review of temporal bone simulation platforms and their uses. Data Sources PubMed literature search. Search terms included temporal bone, temporal bone simulation, virtual reality (VR), and presurgical planning and rehearsal. Discussion Various simulation platforms such as cadaveric bone, three‐dimensional (3D) printed models, and VR simulation have been used for temporal bone surgery training. However, each simulation method has its drawbacks. There is a need to improve upon current simulation platforms to enhance surgical training and skills assessment, as well as a need to explore other clinically significant applications of simulation, such as preoperative planning and rehearsal, in otologic surgery. Conclusions There is no replacement for actual surgical experience, but high‐fidelity temporal bone models such as those produced with 3D printing and computer simulation have emerged as promising tools in otolaryngologic surgery. Improvements in the fidelity of both 3D printed and VR simulators as well as integration of a standardized assessment format would allow for an expansion in the use of these simulation platforms in training and assessment. Level of Evidence 5

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Elements of virtual temporal bone surgery: Manipulandum format may be more important to surgeons than haptic device force capabilities

Unger

Sepehri

Rampersad

et al. 2017

Laryngoscope Investig Oto

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BackgroundTemporal bone simulations are critiqued for poor drill‐bone interaction. This project appraises the import of increasing haptic device and manipulandum fidelity on the perceived realism of drilling a virtual temporal bone.Virtual surgical contact forces rely on haptic device fidelity and are transmitted through a manipulandum. With identical software, both device hardware and manipulandum may each contribute to realism. We compare the three degrees of freedom (DOF), 3N Geomagic Touch (3D Systems, SC) to a 6DOF, 5.5N HD2 (Quanser, ON) with the both standard (“HD2–Standard”) and in‐house customized otic drill manipulandum (“HD2–Modified”).MethodsSix otologic surgeons performed three virtual mastoidectomy surgeries on a temporal bone surgical simulator. The HD2 manipulandum was modified for attached otic drill with gravity compensation and requisite mechanical modifications. Surgeons, in random order, performed the dissection with the different hardware platforms.ResultsTwo‐tailed t‐tests demonstrate that for the acoustic properties of each simulation, the HD2–Modified manipulandum was favored (p ≤ 0.0004). For overall similarity of bone, both HD2–Standard (p ≤ 0.05) HD2–Modified (p ≤ 0.03)) were favored over the Geomagic; however they were not appreciably different when directly compared to each other. There was no preference for increasing haptic device fidelity in virtual drill bone interaction.In forced rank, users favored the HD2–Modified in osseus, vibrational and overall realism, as well as being preferred for education and preoperative rehearsal (p ≤ 0.0164).ConclusionIncreasing manipulandum realism was favored. However surprisingly, there was no preference for increased device fidelity, illustrating incremental stiffness had nominal impact. There may be a ceiling to drill bone interaction in virtual haptic simulation.Level of Evidence2b.

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Mixed reality temporal bone surgical dissector: mechanical design

Cited by 15 publications

References 6 publications

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

A review of simulation applications in temporal bone surgery

Elements of virtual temporal bone surgery: Manipulandum format may be more important to surgeons than haptic device force capabilities

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