The accuracy of an electromagnetic navigation system in lateral skull base approaches

Komune, Noritaka; Matsushima, Ken; Matsuo, Seiichiro; Safavi–Abbasi, Sam; Matsumoto, Nozomu; Rhoton, Albert L.

doi:10.1002/lary.25998

Cited by 34 publications

(30 citation statements)

References 30 publications

(47 reference statements)

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“…An anterior/posterior and left/right ranking did not bring forth any correlation with TRE. This is in contrast with some other studies, where an increase in TRE was observed when targeting more posteriorly located fiducial sites [13], whereas Komune et al [15] found no difference in TRE depending on the location in lateral skull base surgery. Possible reasons for these diverging results may be the use of different navigation systems as well as varying distances between the fiducial target sites and the reference frame among the various study groups.…”

Section: Sources Of Errorcontrasting

confidence: 95%

“…This means that addition of landmarks to surface registration did not improve accuracy of surgical navigation. Overall, the TRE values observed in this study were within the range reported in other studies of electromagnetic registration [13,15,[21][22][23][24]. We were also interested, how accuracy of surface registration compares to the reference registration mode using bone anchored fiducials applied before the preoperative CT scan.…”

Section: Addition Of Landmark Registration To Surface Registration DIsupporting

confidence: 80%

“…Current data comparing different registration modes in electromagnetic tracking suggest that point by point registration using bone anchored fiducials results in lowest TRE, i.e. best accuracy [15,16]. Some surgical navigation systems offer the possibility to use both, surface registration and in addition point by point landmark registration in the same run [16].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of surface registration in cranial electromagnetic navigation

Runge¹,

Steinbichler²,

Giotakis³

et al. 2018

Otorhinolaryngol Head Neck Sur

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Purpose: We evaluated the accuracy of surface registration with and without additional landmark registration during cranial electromagnetic navigation. Results were referenced to point by point registration with bone anchored fiducials. Methods:Using a commercially available electromagnetic navigation system, 4 rhinologic surgeons applied surface registration alone (SurfReg) and surface registration with additional anatomic landmarks (CombReg) in a macerated human skull. Point by point registration using bone anchored fiducials (RefReg) served as reference. Target registration error (TRE) served as a measure for accuracy. For TRE calculation, 16 landmarks on the viscerocranium, the frontal skull base and the middle cranial fossa were touched with a probe and the distance of the probe and the target was measured on a screenshot of the corresponding CT image in three planes. A mixed regression model with registration mode as fixed factor and examiner and target as random factors was used.Results: Mean (95% CI) TRE for SurfReg was 1.12 (0.86 to 1.39) mm and 1.21 (0.94 to 1.47) mm for CombReg (p=0.13). TRE of the RefReg was significantly lower (0.91 mm; 0.64 to 1.18; p<0.001). TRE varied significantly depending on target screw position. TRE did not vary significantly among different examiners. Conclusion:Surface registration is considered sufficiently accurate for clinical application during FESS and frontal skull base surgery. Additional landmarks did not improve accuracy when compared with surface registration alone. Additional time for landmark registration can therefore be spared.

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Section: Sources Of Errorcontrasting

confidence: 95%

Section: Addition Of Landmark Registration To Surface Registration DIsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of surface registration in cranial electromagnetic navigation

Runge¹,

Steinbichler²,

Giotakis³

et al. 2018

Otorhinolaryngol Head Neck Sur

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“…Inferior laboratory accuracy has been published for magnetic tracking at the lateral skull base, 1 but identification of 45% (middle fossa) and 65% (translabyrinthine approach) of landmarks with less than 0.5 mm target registration error in cadavers was recently reported. 2 In this survey, navigation is reported to be used more often at the lateral skull base in neurosurgery, especially at the middle fossa. The difference to the percentage of navigation used in posterior fossa surgery is striking, where navigation is less in favor.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of Navigation in Lateral Skull Base Surgery: Results of a Multispecialty National Survey among Skull Base Surgeons in Germany

2018

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Objective To analyze the current clinical use of navigation at the lateral skull base among skull base surgeons in Germany. Methods A web-based questionnaire was provided to surgeons being head of the department and member of one of the following scientific societies: German Society of Head and Neck Surgery, Maxillo-Facial Surgery, Neurosurgery, and German Skull Base Society. Replies were recorded anonymously. The questionnaire included the estimated case load per year and percent of surgery performed with navigation (middle and posterior fossa), type of navigation, estimates of intraoperative inaccuracy, and reasons for not using navigation. Results Eighty nine out of 99 replies met requirements for final analysis. Overall, 37% of skull base surgeons use navigation on a regular basis (15% use no navigation). Optical tracking is more frequently used than magnetic tracking (71 vs 19). At the middle fossa, ENT surgeons split into routine users (n = 10/36) and rare users (n = 16/36), the latter stating navigation inaccuracy as a major reason for neglecting navigation. Neurosurgeons use navigation at the middle fossa significantly more often and criticize navigation inaccuracy less. At the posterior fossa, navigation is used less frequently by both ENT and neurosurgeons with similar rates of estimated inaccuracy. Conclusions A moderate use of navigation at the lateral skull base was demonstrated. Insufficient accuracy causes ENT surgeons to frequently omit navigation at the middle fossa (not neurosurgeons) and posterior fossa (also neurosurgeons). Higher intraoperative navigation accuracy is needed to enhance the use of navigation at the lateral skull base.

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“…En otra investigación cadavérica sobre abordaje lateral de base de crá-neo, se midió el error de registro en 28 puntos de referencia quirúrgicos, analizando veinte huesos temporales de cadáveres mediante navegación electromagnética. Once de 17 objetivos (65%) en el enfoque translaberíntico y cinco de 11 objetivos (45%) en el enfoque de fosa media se identificaron, en el sistema de navegación, con error de registro de menos de 0,5 mm 15 . Concluyendo que el sistema de navegación electromagnético tiene una precisión suficiente para ser utilizado también en ciertos casos de cirugía de base de cráneo lateral.…”

Section: Discussionunclassified