Advances in Surgical Navigation

Design and validation of an open-source library of dynamic reference frames for research and education in optical tracking

Dynamic reference frames (DRFs) are a common component of modern surgical tracking systems; however, the limited number of commercially available DRFs poses a constraint in developing systems, especially for research and education. This work presents the design and validation of a large, open-source library of DRFs compatible with passive, single-face tracking systems, such as Polaris stereoscopic infrared trackers (NDI, Waterloo, Ontario). An algorithm was developed to create new DRF designs consistent with intra- and intertool design constraints and convert to computer-aided design (CAD) files suitable for three-dimensional printing. A library of 10 such groups, each with 6 to 10 DRFs, was produced and tracking performance was validated in comparison to a standard commercially available reference, including pivot calibration, fiducial registration error (FRE), and target registration error (TRE). Pivot tests showed calibration error [Formula: see text], indistinguishable from the reference. FRE was [Formula: see text], and TRE in a CT head phantom was [Formula: see text], both equivalent to the reference. The library of DRFs offers a useful resource for surgical navigation research and could be extended to other tracking systems and alternative design constraints.

An update on attitudes and use of image-guided surgery

BACKGROUND

The aim of this study was to compare 2010 access to, usage of, and attitudes toward image-guided surgery (IGS) for endoscopic sinus surgery and anterior skull-base surgery to those in 2005.

METHODS

A mail survey of American Rhinologic Society (ARS) members was performed in January 2010. Results were compared to results from the same survey mailed in January 2005.

RESULTS

Significantly more respondents in 2010 had access to IGS compared to 2005 (94.6% vs 86%, p = 0.002). Compared to 2005, IGS was used in a greater percentage of cases in 2010 (p < 0.0001). More respondents in 2010 felt that IGS is indicated for primary anterior ethmoidectomy, revision anterior ethmoidectomy, primary total ethmoidectomy, Lothrop procedure, cerebrospinal fluid (CSF) leak repair, tumor surgery, orbital decompression, and optic nerve decompression (all p < 0.05). Similar to 2005, region, residency completion date, and availability of IGS in residency had no measureable effect on attitudes toward IGS. As in 2005, availability of IGS was associated with a greater feeling of its necessity in 2010.

CONCLUSION

IGS availability has grown significantly and nearly all ARS members now have access. Estimates of use by respondents have also increased over the last 5 years, particularly for ethmoid and advanced procedures. Revision surgery and advanced procedures continue to be chief indications for IGS use. As in 2005, the results of this survey reflect the opinion of the respondents, and do not necessarily reflect the views of the ARS or of practicing otolaryngologists in general.