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A bone-thickness map as a guide for bone-anchored port implantation surgery in the temporal bone

机译:骨厚度图作为颞骨骨锚定端口植入手术的指南

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摘要

The bone-anchored port (BAP) is an investigational implant, which is intended to be fixed on the temporal bone and provide vascular access. There are a number of implants taking advantage of the stability and available room in the temporal bone. These devices range from implantable hearing aids to percutaneous ports. During temporal bone surgery, injuring critical anatomical structures must be avoided. Several methods for computer-assisted temporal bone surgery are reported, which typically add an additional procedure for the patient. We propose a surgical guide in the form of a bone-thickness map displaying anatomical landmarks that can be used for planning of the surgery, and for the intra-operative decision of the implant’s location. The retro-auricular region of the temporal and parietal bone was marked on cone-beam computed tomography scans and tridimensional surfaces displaying the bone thickness were created from this space. We compared this method using a thickness map (n = 10) with conventional surgery without assistance (n = 5) in isolated human anatomical whole head specimens. The use of the thickness map reduced the rate of Dura Mater exposition from 100% to 20% andudOPEN ACCESSudMaterials 2013, 6 5292udsuppressed sigmoid sinus exposures. The study shows that a bone-thickness map can beudused as a low-complexity method to improve patient’s safety during BAP surgery in theudtemporal bone.
机译:骨锚固端口(BAP)是一种研究性植入物,旨在固定在颞骨上并提供血管通路。有许多植入物利用了颞骨的稳定性和可用空间。这些设备的范围从植入式助听器到经皮端口。在颞骨外科手术期间,必须避免伤害关键的解剖结构。报道了几种计算机辅助颞骨手术的方法,这些方法通常为患者增加了额外的程序。我们建议以骨厚图的形式提供手术指南,其中应显示解剖学界标,可用于规划手术以及在手术中确定植入物的位置。在锥形束计算机断层扫描中标记颞骨和顶骨的耳后区域,并从该空间创建显示骨骼厚度的三维表面。我们将这种使用厚度图(n = 10)的方法与传统手术在没有帮助(n = 5)的情况下在孤立的人体解剖学全头标本中进行了比较。厚度图的使用将Dura Mater暴露的比率从100%降低到20%,并且 udOPEN ACCESS udMaterials 2013,6 5292 uds减少了乙状窦暴露。研究表明,可以将骨厚度图用作低复杂度的方法,以提高BAP手术中ud颞骨患者的安全性。

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