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Aweeda M, Adegboye F, Yang SF, Topf MC. Enhancing Surgical Vision: Augmented Reality in Otolaryngology-Head and Neck Surgery. JOURNAL OF MEDICAL EXTENDED REALITY 2024; 1:124-136. [PMID: 39091667 PMCID: PMC11290041 DOI: 10.1089/jmxr.2024.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 08/04/2024]
Abstract
Augmented reality (AR) technology has become widely established in otolaryngology-head and neck surgery. Over the past 20 years, numerous AR systems have been investigated and validated across the subspecialties, both in cadaveric and in live surgical studies. AR displays projected through head-mounted devices, microscopes, and endoscopes, most commonly, have demonstrated utility in preoperative planning, intraoperative guidance, and improvement of surgical decision-making. Specifically, they have demonstrated feasibility in guiding tumor margin resections, identifying critical structures intraoperatively, and displaying patient-specific virtual models derived from preoperative imaging, with millimetric accuracy. This review summarizes both established and emerging AR technologies, detailing how their systems work, what features they offer, and their clinical impact across otolaryngology subspecialties. As AR technology continues to advance, its integration holds promise for enhancing surgical precision, simulation training, and ultimately, improving patient outcomes.
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Affiliation(s)
- Marina Aweeda
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Feyisayo Adegboye
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Shiayin F. Yang
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael C. Topf
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- School of Engineering, Vanderbilt University, Nashville, Tennessee, USA
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Patel R, Acharya R, Shah S, Desai C, Raveshia D, Panesar H, Patel N, Mcconaghie G, Cain DC, Parmar D, Banerjee R, Singh R. Five historical innovations that have shaped modern otolaryngological surgery. J Perioper Pract 2024:17504589241244996. [PMID: 38828977 DOI: 10.1177/17504589241244996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Throughout history, many innovations have contributed to the development of modern otolaryngological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern otolaryngological surgery: Operative Microscope, Hopkins Rigid Endoscope, Laryngeal Nerve monitoring, Cochlear implants and Laser surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of otolaryngological surgery and their ongoing relevance in contemporary and perioperative practice.
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Affiliation(s)
- Ravi Patel
- Department of Trauma and Orthopaedics, The Shrewsbury and Telford Hospital NHS Trust, The Princess Royal Hospital, Telford, UK
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Radhika Acharya
- Department of Intensive Care, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Saumil Shah
- Department of Otolaryngology, The Princess Royal Hospital, Telford, UK
| | - Chaitya Desai
- Department of Urology, Walsall Manor Hospital, Walsall Healthcare NHS Trust, Walsall, UK
| | - Dimit Raveshia
- Department of General Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Harrypal Panesar
- Department of Otolaryngology, The Princess Royal Hospital, Telford, UK
| | | | - Greg Mcconaghie
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - David Charles Cain
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Dilen Parmar
- Department of Otolaryngology, The Princess Royal Hospital, Telford, UK
| | - Robin Banerjee
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Rohit Singh
- Department of Trauma and Orthopaedics, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
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Guo H, Somayajula SA, Hosseini R, Xie P. Improving image classification of gastrointestinal endoscopy using curriculum self-supervised learning. Sci Rep 2024; 14:6100. [PMID: 38480815 PMCID: PMC10937990 DOI: 10.1038/s41598-024-53955-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/07/2024] [Indexed: 03/17/2024] Open
Abstract
Endoscopy, a widely used medical procedure for examining the gastrointestinal (GI) tract to detect potential disorders, poses challenges in manual diagnosis due to non-specific symptoms and difficulties in accessing affected areas. While supervised machine learning models have proven effective in assisting clinical diagnosis of GI disorders, the scarcity of image-label pairs created by medical experts limits their availability. To address these limitations, we propose a curriculum self-supervised learning framework inspired by human curriculum learning. Our approach leverages the HyperKvasir dataset, which comprises 100k unlabeled GI images for pre-training and 10k labeled GI images for fine-tuning. By adopting our proposed method, we achieved an impressive top-1 accuracy of 88.92% and an F1 score of 73.39%. This represents a 2.1% increase over vanilla SimSiam for the top-1 accuracy and a 1.9% increase for the F1 score. The combination of self-supervised learning and a curriculum-based approach demonstrates the efficacy of our framework in advancing the diagnosis of GI disorders. Our study highlights the potential of curriculum self-supervised learning in utilizing unlabeled GI tract images to improve the diagnosis of GI disorders, paving the way for more accurate and efficient diagnosis in GI endoscopy.
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Affiliation(s)
- Han Guo
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, 92093, USA
| | - Sai Ashish Somayajula
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, 92093, USA
| | - Ramtin Hosseini
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, 92093, USA
| | - Pengtao Xie
- Department of Electrical and Computer Engineering, University of California, San Diego, San Diego, 92093, USA.
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Uchida M, Morioka S, Mizutari K. Experiences of Percutaneous Endoscopic Approach for the Mastoid Lesions: A Novel Minimally Invasive Ear Surgery. Otol Neurotol 2024; 45:169-175. [PMID: 38206065 DOI: 10.1097/mao.0000000000004077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVES We developed a novel keyhole surgery, named "percutaneous endoscopic ear surgery" (PEES), with the aim of further reducing the invasiveness of otologic surgery. We reported the cases we encountered and retrospectively analyzed the invasiveness of PEES. METHODS We analyzed the ears of eight patients who underwent PEES for mastoid lesions that could not be manipulated with transcanal endoscopic ear surgery (TEES) at our hospital between July 2021 and November 2022. We performed PEES alone in three patients, including one case of type A (preauricular incision) and two cases of type B (retroauricular incision). The last five patients underwent combined endoscopic ear surgery, which is simultaneous PEES and TEES. In these cases, one patient underwent type A PEES, and four patients underwent type B PEES. RESULTS PEES was performed in all patients without converting to conventional microscopic mastoidectomy. The mean length of skin incisions was 19.1 ± 4.5 mm, which was smaller than that in conventional mastoidectomy. In all cases, the average length of the major axis of the keyhole was <10 mm, indicating that sufficient minimally invasive surgery was achieved. The average depth from the keyhole to the deepest site was 21.6 ± 8.9 mm. There was no change in the mean hearing level before and after the surgery. CONCLUSION PEES is a minimally invasive procedure for manipulating lesions in the mastoid. In addition, the combination of PEES and TEES is an ideal, minimally invasive procedure that can be used to treat all regions of the temporal bone.
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Affiliation(s)
- Masaya Uchida
- Department of Otorhinolaryngology Tracheoesophageal Surgery, Japanese Red Cross, Kyoto Daini Hospital, Kyoto
| | - Shigefumi Morioka
- Department of Otorhinolaryngology Tracheoesophageal Surgery, Japanese Red Cross, Kyoto Daini Hospital, Kyoto
| | - Kunio Mizutari
- Department of Otolaryngology, National Defense Medical College, Saitama, Japan
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Conway RM, Fan CJ, Choi JS, Babu K, Mallany HP, Babu SC. Exoscope-Assisted Stapedotomy: Evaluation of Safety and Efficacy. Otol Neurotol 2023; 44:978-982. [PMID: 37939357 DOI: 10.1097/mao.0000000000004042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Evaluate the safety and efficacy of exoscope-assisted stapedotomy. STUDY DESIGN Retrospective chart review. SETTING Tertiary care neurotology clinic. PATIENTS Adult patients with otosclerosis undergoing stapedotomy. INTERVENTIONS Primary stapedotomy. MAIN OUTCOME MEASURES Evaluation of audiologic outcomes, including pure-tone average, bone-conduction thresholds, word recognition score, and air-bone gap. Complications, need for scutum removal, and length of surgery were also evaluated. RESULTS A total of 47 patients were identified, and 24 patients underwent surgery with the microscope and 22 with the exoscope. There were significant improvements in pure-tone average, mean bone-conduction thresholds, and air-bone gap for both groups. There was no difference in preoperative or postoperative audiologic status for either group. There was no difference in rates of dysgeusia, chorda tympani nerve damage, dizziness, or facial paresis in either group. CONCLUSIONS This study indicates similar audiologic outcomes, complication profiles, and visualization when comparing exoscopic and microscopic stapedotomy. Demonstrated here, exoscopic stapedotomy can be safely performed in a transcanal manner.
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Affiliation(s)
| | | | | | - Kavan Babu
- Michigan State University, East Lansing, Michigan
| | - Hugh P Mallany
- University of New England School of Osteopathic Medicine, Biddeford, Maine
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Joo H, Lin Z, Yesantharao L, Formeister E, Razavi C, Patel M, Carey J, Taylor R, Galaiya D. Intraoperative Neck Angles in Endoscopic and Microscopic Otologic Surgeries. Otolaryngol Head Neck Surg 2023; 168:1494-1501. [PMID: 36794784 DOI: 10.1002/ohn.226] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/19/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To quantitatively compare the ergonomic risk of otologic surgeries performed with endoscopes and microscopes. STUDY DESIGN Observational cross-sectional study. SETTING Operating room of a tertiary academic medical center. METHODS Intraoperative neck angles of otolaryngology attendings, fellows, and residents were assessed during 17 otologic surgeries using inertial measurement unit sensors. Sensors were attached midline between the shoulder blades and on the posterior scalp of participants and were calibrated just prior to beginning each case. Quaternion data were used to calculate neck angles during periods of active surgery. RESULTS Endoscopic and microscopic cases included similar percentages of time in high-risk neck positions, 75% and 73%, respectively, according to a validated ergonomic risk assessment tool, the Rapid Upper Limb Assessment. However, microscopic cases included a higher percentage of time spent in extension (25%) compared to endoscopic cases (12%) (p < .001). When examining the magnitude of average flexion and extension angles, endoscopic and microscopic cases were not significantly different. CONCLUSION Utilizing intraoperative sensor data, we found that both endoscopic and microscopic approaches in otologic surgery were associated with high-risk neck angles, which can result in sustained neck strain. These results suggest that optimal ergonomics may be better achieved by the consistent application of basic ergonomic principles than by changing the technology in the operating room.
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Affiliation(s)
- Hyonoo Joo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zihao Lin
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lekha Yesantharao
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Eric Formeister
- Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina, USA
| | - Christopher Razavi
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Millan Patel
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - John Carey
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Russ Taylor
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deepa Galaiya
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
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Tu LJ, Fina M, Golub JS, Kazahaya K, Quesnel AM, Tawfik KO, Cohen MS. Current Trends in Endoscopic Ear Surgery. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e023. [PMID: 38516579 PMCID: PMC10950159 DOI: 10.1097/ono.0000000000000023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/21/2022] [Indexed: 03/23/2024]
Affiliation(s)
- Leona J. Tu
- Drexel University College of Medicine, Philadelphia, PA
| | - Manuela Fina
- Department of Otolaryngology—Head and Neck Surgery, University of Minnesota, Minneapolis, MN
| | - Justin S. Golub
- Department of Otolaryngology—Head and Neck Surgery, Valegos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY
| | - Ken Kazahaya
- Division of Pediatric Otolaryngology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Alicia M. Quesnel
- Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Kareem O. Tawfik
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Michael S. Cohen
- Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
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Ali H, Sharif M, Yasmin M, Rehmani MH. A shallow extraction of texture features for classification of abnormal video endoscopy frames. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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