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How precise are oral splints for frameless stereotaxy in guided ear, nose, throat, and maxillofacial surgery: a cadaver study
BACKGROUND: Computer-assisted surgery optimises accuracy and serves to improve precise surgical procedures. We validated oral splints with fiducial markers by testing them against rigid bone markers. METHODS: We screwed twenty bone anchors as fiducial markers into different regions of a dried skull...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245614/ https://www.ncbi.nlm.nih.gov/pubmed/34195878 http://dx.doi.org/10.1186/s41747-021-00223-3 |
Sumario: | BACKGROUND: Computer-assisted surgery optimises accuracy and serves to improve precise surgical procedures. We validated oral splints with fiducial markers by testing them against rigid bone markers. METHODS: We screwed twenty bone anchors as fiducial markers into different regions of a dried skull and measured the distances. After computed tomography (CT) scanning, the accuracy was evaluated by determining the markers’ position using frameless stereotaxy on a dry cadaver and indicated on the CT scan. We compared the accuracy of chairside fabricated oral splints to standard registration with bone markers immediately after fabrication and after a ten-time use. Accuracy was calculated as deviation (mean ± standard deviation). For statistical analysis, t test, Kruskal-Wallis, Tukey's, and various linear regression models, such as the Pearson's product–moment correlation coefficient, were used. RESULTS: Oral splints showed an accuracy of 0.90 mm ± 0.27 for viscerocranium, 1.10 mm ± 0.39 for skull base, and 1.45 mm ± 0.59 for neurocranium. We found an accuracy of less than 2 mm for both splints for a distance of up to 152 mm. The accuracy persisted even after ten times removing and reattaching the splints. CONCLUSIONS: Oral splints offer a non-invasive indicator to improve the accuracy of image-guided surgery. The precision is dependent on the distance to the target. Up to 150-mm distance, a precision of fewer than 2 mm is possible. Dental splints provide sufficient accuracy than bone markers and may opt for higher precision combined with other non-invasive registration methods. |
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