Abstract
Objective: 1) To investigate the feasibility of performing case specific surgical rehearsal (CSSR) using a virtual reality (VR) temporal bone simulator. 2) To identify potential clinical applications in temporal bone surgery.
Method: Preclinical study conducted in a London teaching hospital. Twenty-four cadaver temporal bones were CT scanned and uploaded onto the Voxelman simulator. Sixteen participants (trainer and trainee group) performed 3 dissection tasks on VR and cadaver models. CSSR was assessed for feasibility and clinical applications using a 5-point Likert scale.
Results: The upload process required a semi-automated system. The average time for each upload was 15 minutes. Suboptimal reconstruction occurred (n = 4) when the mastoid process and ossicular chain were not captured. CSSR rated highly among both groups (Likert score >4) for surgical anatomy (75%), facilitating surgical planning (75%), and training (94%). Both groups reported suboptimal realism compared to cadaver models due to poor depth perception. The most relevant clinical procedures for CSSR were ossicular chain surgery, pediatric cochlear implantation, and congenital anomalies. CSSR involving the facial nerve and cholesteatoma surgery were not feasible due to suboptimal soft tissue VR representation.
Conclusion: The process of uploading CT data onto a temporal bone simulator to perform CSSR is feasible using a semi-automated system. It represents a promising application for selected clinical procedures. Further clinical evaluation is warranted to assess the potential benefit.
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