Improvement of navigation in the temporal bone through combination of Flat-panel CT and electromagnetic navigation

Introduction:

Ear surgery has developed continuously in recent decades. The possibilities of cross-sectional imaging and navigation also include innovations such as Flat-panel CT and electromagnetic navigation. Aim of this study was to examine whether the Flat-panel CT can be combined practically with electromagnetic navigation and whether it can be used in temporal bone surgery with sufficient accuracy.

Methods:

For this purpose, Flat-panel CT examinations were performed in 10 postmortem human temporal bones (Dyna-CT, Siemens) and were then recorded with the electromagnetic navigation system NAV1™ from Storz. Calibration was carried out with the 4-point calibration method and defined structures (posterior, anterior, horizontal semicircular canal; incus, stapes) were approached to measure navigation accuracy.

Results:

The electromagnetic navigation in the human temporal bone was easy to integrate. The different structures could be precisely identified by nagigation Accuracy added up to a registration error of mean 0.28 and max 0.38 and measured deviations of < 1 mm.

Conclusion:

The combination of Flat-panel CT and electromagnetic navigation is an easy to integrate and combine method for monitoring in the temporal bone. Various otological applications in patients are possible, e.g. the intraoperative control of a cochlear implant electrode within the cochlea.

Publication History

Publication Date:
23 April 2019 (online)