Comparison of cadaveric and isomorphic virtual haptic simulation in temporal bone training

Journal of Otolaryngology-Head & Neck Surgery

Jordan B Hochman⁴  Charlotte Rhodes³  Justyn Pisa¹  Jay Kraut³  Bertram Unger²  Dana Wong⁵ 

[1] Surgical Hearing Implant Program, Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, GB421, 820 Sherbrook Street, Winnipeg R3A 1R9, Manitoba, Canada;Clinical Learning and Simulation Facility, Department of Medical Education, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;Department of Medical Education, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Manitoba, GB421, 820 Sherbrook Street, Winnipeg R3A 1R9, Manitoba, Canada;Department of Otolaryngology Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada

关键词: Temporal bone;    Real time marching cubes;    Haptic;    Medical simulation;   

Others  :  1143924
DOI  :  10.1186/s40463-014-0031-9

 received in 2014-05-27, accepted in 2014-07-18,  发布年份 2014

【 摘 要 】

Background

Virtual surgery may improve learning and provides an opportunity for pre-operative surgical rehearsal. We describe a novel haptic temporal bone simulator specifically developed for multicore processing and improved visual realism. A position locking algorithm for enhanced drill-bone interaction and haptic fidelity is further employed. The simulation construct is evaluated against cadaveric education.

Methods

A voxel-based simulator was designed for multicore architecture employing Marching Cubes and Laplacian smoothing to perform real-time haptic and graphic rendering of virtual bone.

Ten Otolaryngology trainees dissected a cadaveric temporal bone (CTB) followed by a virtual isomorphic haptic model (VM) based on derivative microCT data. Participants rated 1) physical characteristics, 2) specific anatomic constructs, 3) usefulness in skill development and 4) perceived educational value. The survey instrument employed a Likert scale (1-7).

Results

Residents were equivocal about the physical properties of the VM, as cortical (3.2?±?2.0) and trabecular (2.8?±?1.6) bone drilling character was appraised as dissimilar to CTB. Overall similarity to cadaveric training was moderate (3.5?±?1.8). Residents generally felt the VM was beneficial in skill development, rating it highest for translabyrinthine skull-base approaches (5.2?±?1.3). The VM was considered an effective (5.4?±?1.5) and accurate (5.7?±?1.4) training tool which should be integrated into resident education (5.5?±?1.4). The VM was thought to improve performance (5.3?±?1.8) and confidence (5.3?±?1.9) and was highly rated for anatomic learning (6.1?±?1.9).

Conclusion

Study participants found the VM to be a beneficial and effective platform for learning temporal bone anatomy and surgical techniques. They identify some concern with limited physical realism likely owing to the haptic device interface. This study is the first to compare isomorphic simulation in education. This significantly removes possible confounding features as the haptic simulation was based on derivative imaging.

【 授权许可】

   
2014 Wong et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Fennessy BG, Sullivan PO: Establishing a temporal bone laboratory: considerations for ENT specialist training. Ir J Med Sci 2009, 178:393-395.
• [2]Fried MP, Uribe JI, Sadoughi B: The role of virtual reality in surgical training in otorhinolaryngology. Curr Opin Otolaryngol Head Neck Surg 2007, 15:163-169.
• [3]George AP, De R: Review of temporal bone dissection teaching: how it was, is and will be. J Laryngol Otol 2010, 124:119-125.
• [4]Morris D, Sewell C, Barbgli F, Salisbury K, Blevins NH, Girod S: Visuohaptic simulation of bone surgery for training and evaluation. IEEE Comput Graph Appl 2006, 6:48-57.
• [5]Wiet GJ, Bryan J, Dodson E, Sessanna D, Stredney D, Schmalbrock P, Welling B: Virtual temporal bone dissection simulation. Stud Health Tech Informat 2000, 70:378-384.
• [6]Pflesser B, Petersik A, Tiede U, Höhne KH, Leuwer R: Volume cutting for virtual petrous bone surgery. Comput Aided Surg 2002, 7(2):74-83.
• [7]Agus M, Giachetti A, Gobbetti E, Zanetti G, Zorcolo A, John NW, Stone RJ: Mastoidectomy simulation with combined visual and haptic feedback. MMVR 2002, 85:17-23.
• [8]Sorensen MS, Mosegaard J, Trier P: The visible ear simulator: a public PC application for GPU-accelerated haptic 3D simulation of ear surgery based on the visible ear data. Otol Neurotol 2009, 30(4):484-487.
• [9]Jackson A, John NW, Thacker NA, Ramsden RT, Gillespie JE, Gobbetti E, Zanetti G, Stone R, Linney AD, Alusi GH, Franceshini SS, Scherdtner A, Emmen A: Developing a virtual reality environment in petrous bone surgery: a state-of-the-art review. Otol Neurotol 2002, 23:111-121.
• [10]Zhao YC, Kennedy G, Yukawa K, Pyman B, O¿Leary S: Improving temporal bone dissection using self-directed virtual reality simulation: results of a randomized blinded control trial. Otolaryngol Head Neck Surg 2011, 144(3):357-364.
• [11]Hochman J, Kraut J, Kazmerick K, Unger B: Generation of 3D printed temporal bone model with internal fidelity and validation of the mechanical construct. Otolaryngol Head Neck Surg 2013, 150(3):448-454.
• [12]Roosli C, Sim JH, Mochel H, Mokosch M, Probst R: An artificial temporal bone as a training tool for cochlear implantation. Otol Neurotol 2013, 34(6):1048-1051.
• [13]Zirkle M, Roberson DW, Leuwer R, Dubrowski A: Using a virtual reality temporal bone simulator to assess otolaryngology trainees. Laryngoscope 2007, 117:258-263.
• [14]Reddy-Kolanu G, Alderson D: Evaluating the effectiveness of the voxel-man TempoSurg virtual reality simulator in facilitating learning mastoid surgery. Ann Roy Coll Surg Engl 2011, 93:205-208.
• [15]Wiet GJ, Stredney D, Kerwin T, Hittle B, Fenandez SA, Abdel-Rasoul M, Welling B: Virtual temporal bone dissection system: development and testing. Laryngoscope 2012, 122(Suppl 1):S1-S12.
• [16]Francis HW, Malik MU, Varela DADV, Barffour MW, Chien WW, Carey JP, Niparko JK, Bhatti NI: Technical skills improve after practice on virtual-reality temporal bone simulator. Laryngoscope 2012, 122:1385-1391.
• [17]Khemani S, Arora A, Singh A, Tolley N, Darzi A: Objective skills assessment and construct validation of a virtual reality temporal bone simulator. Otol Neurotol 2012, 33:1225-1231.
• [18]Kerwin T, Wiet G, Stredney D, Shen H: Automatic scoring of virtual mastoidectomies using expert scoring. Int J Comput Assist Robot Surg 2012, 7:1-11.
• [19]Kraut J, Hochman JB, Unger B: Temporal bone surgical simulation employing a MultiCore architecture. In Proceedings of the 26thAnnual IEEE Canadian Conference on Electrical and Computer Engineering: 5 ¿ 8 May 2013; Regina, SK. Edited by Yao J, Mehrandezh M, Paranjape R, Gelowitz G. ?: IEEE; 2013:1¿6.
• [20]Morris D, Sewell C, Blevins N, Barbagli F, Salisbury K: A collaborative virtual environment for simulation of temporal bone surgery. MICCAI 2004, 3217:319-327.
• [21]Bryan JA: A Virtual Temporal Bone Dissection Simulation. In Master of Science Thesis. Ohio State University, Department of Computer and Information Science, Columbus, Ohio; 2001.
• [22][http://www.daimi.au.dk/~trier/VES_blog/] webcite Visible Ear Simulation Manual. [ November 2012]
• [23]Leuwer R, Petersik A, Pflesser B, Pommert A, Tolsdorff B, Hohne KH, Tiede U: Voxel-man TempoSurg: a virtual reality temporal bone surgery simulator. J Jpn Soc Head Neck Surg 2007, 17(3):203-207.
• [24]Lorensen WE, Cline HE: Marching cubes: a high resolution 3D surface construction algorithm. Comput Graph 1987, 21(4):163-169.
• [25]Vollmer J, Mencel R, Muller H: Improved laplacian smoothing of noisy surface meshes. Comput Graph Forum 1999, 18(3):131-138.