Width of the extended facial recess: a numerical study of ultrahigh-resolution computed tomography and its implications in minimally invasive otologic surgery
| Autor: | D Ruimi, E Bar-Meir, C B Teszler, Michal Luntz |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Otologic surgery Ear Middle Image processing Temporal bone medicine Humans Minimally Invasive Surgical Procedures Tympanic cavity Aged Aged 80 and over Round window business.industry Middle Aged Facial nerve Sensory Systems Facial Nerve medicine.anatomical_structure Otorhinolaryngology Ultrahigh resolution Calipers Female Neurology (clinical) Radiology business Otologic Surgical Procedures Tomography X-Ray Computed |
| Zdroj: | Otologyneurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 26(4) |
| ISSN: | 1531-7129 |
| Popis: | BACKGROUND Methods of minimally invasive computer-assisted otologic surgery lag behind other fields. The reason seems to be the extremely small dimensions of the corridors between important structures in the temporal bone and the fact that these structures are encased in bony frameworks, are obscured before drilling, and are not movable. The extended facial recess is a surgical pass to the tympanic cavity. It is bounded medially by the facial nerve and laterally by the tympanic annulus, and varies among individuals. For computer-assisted, minimally invasive temporal bone surgery, high-resolution definition is critically important. AIMS To determine the width of the extended facial recess and evaluate the computerized findings as a pre- and intraoperative aid to otologic surgery planning. METHODS Bilateral temporal bone high-resolution computed tomographic images of 100 male and 100 female patients were measured twice at five levels (caudal to cephalic), first using a window-independent algorithm (extended facial recess, full-width at half-maximum), implemented in a computed tomographic image-processing workstation, and then manually with calipers on the same axial computed tomographic images. RESULTS As expected, the extended facial recess, full-width at half-maximum method yielded the widest values superiorly (4.15 +/- 0.41 mm in the female patients and 4.32 +/- 0.54 mm in the male patients). From this level down, the extended facial recess, full-width at half-maximum method yielded values that tapered gradually to 2.50 +/- 0.56 mm in the female patients and 2.42 +/- 0.46 mm in the male patients at the most interior level. The manual method (extended facial recess, computed tomographic images) yielded a significantly higher value than that obtained with the objective, window-independent method at all levels, and at some levels was higher by as much as one-third. At Level 2, which corresponded roughly to the round window, the extended facial recess was 4.00 +/- 0.65 in the female study group and 4.11 +/- 0.67 mm in the male study group. CONCLUSION Image processing methods such as extended facial recess, full-width at half-maximum method might lead to fine tuning and thus improvement of computer-assisted otologic surgery. Before clinical application and complete dependence on these automated methods during otologic surgery, their reliability should be further validated. |
| Databáze: | OpenAIRE |
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