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Otologic surgery brackmann pdf
(3) The computed data in a matrix form that included the, and the audials one 9 crack position of the drill were transferred from the tracking system software program to the navigation software program.
If, the system generated 900 Hz auditory feedback, while if, 300 Hz feedback was produced (Figure 4(c) ).
As such, the closer the surgical drill approaches to a critical anatomical region, the less the surgeon can access the navigation information that is shown outside the surgeons visual field.
There was some unavoidable time delay of the system when generating the auditory feedback.Then, based on these segmentations, voxel data for the facial nerve, scala tympani, cost accounting a managerial emphasis 14th edition chapter 23 solutions and scala vestibuli were computed and saved as text files.In order to see the navigation monitor, the surgeons visual attention has to be moved from the operating field to the navigation monitor, which causes a temporary interruption of the surgical procedure.The tone was set according game ultimate street football ukuran 320x240 to the relative distance to the two targets; that is, the surgeon heard a high tone when the drill tip was closer to the scala tympani than to the scala vestibuli and a low tone when the drill tip was.(a) The flow chart of the proposed system, (b) monitoring the closest distance between the facial nerve and the drill tip and its direction and (c) the guidance for the scala tympani using auditory feedback with different frequency.Thus, a surgical navigation system can help the surgeon to access the scala tympani without injuring important organs in the complex structure of the temporal bone.When the or was less than 5 mm, the system compared the distance between the and.Each patient, or his/her guardian(s provided written informed consent for the surgical procedures.(a) The scala vestibuli (300 Hz) and (b) the scala tympani (900 Hz).The surgical technique for CI requires the insertion of an electrode into the cochlea to stimulate the auditory nerve, which consists of mastoidectomy and posterior tympanotomy to access the middle ear 2,.This new function improved the usefulness of the audible feedback system, because the surgeon could understand whether the drill was closer to the scala tympani or scala vestibuli, that is, the relative distance, in addition to the absolute distance.For sterilization, the mouth splint was first covered with a sterilized plastic drape and then sterilized infrared markers were mounted on the mouth splint (Figure 2(b) ).The current registration error used in our method is close to the limit of the resolution of the optical tracking system.The system provided information about the closest distance from the drill tip to the surface of the facial nerve, along with the direction to the facial nerve.The navigation software program generated a warning sound when the drill tip approached within 5 mm of either of the targets.Figure 4: The configuration of the proposed surgical navigation system.
Upon setting the facial nerve as a target, the frequency of the warning sound was set according to the absolute distance as reported previously 15, such that the warning tone was set at 300 Hz when the drill tip was closer than 5 mm, 600 Hz when the.
On the other hand, the navigation system generated a high tone (900 Hz) when the surgeon placed the drill tip near the scala tympani, indicating that the drill tip is relatively closer to the correct scala (Figure 7(b) ).Was often the information that the surgeon wanted to know.(2) In the operating room, the saved voxel data were first input into the developed software program.In addition, the risk increases in revision surgery or in patients with malformation of the ear, because these conditions make it more difficult for the surgeon to identify the anatomical landmarks of the temporal bone.The surgeon cannot see the navigation monitor while drilling the bone.However, the use of a surgical microscope has restricted the effectiveness of the surgical navigation because it has been difficult to deliver the navigational information to the surgeon from outside of the surgeons visual attention.The system informed the surgeon about the degree of the risk in advance using both visual signals and auditory feedback.Figure 6: Monitoring the facial nerve (a) before and (b) after passing the facial nerve.Figure 3: Image-to-patient registration using the preregistered stamp method.Figure 1: The typical situation in the operating room when using a conventional surgical navigation system.Figure 2: The minimally invasive mouth splint for the patients reference (a) and its sterilization (b).
We have recently developed an auditory feedback system as a new interface between the surgeon and the surgical navigation computer.