The endonasal patient reference tracker: a novel solution for accurate noninvasive electromagnetic neuronavigation.

Journal of Neurosurgery
Ayguel WurzerStefan Wolfsberger

Abstract

Electromagnetic (EM) navigation provides the advantages of continuous guidance and tip-tracking of instruments. The current solutions for patient reference trackers are suboptimal, as they are either invasively screwed to the bone or less accurate if attached to the skin. The authors present a novel EM reference method with the tracker rigidly but not invasively positioned inside the nasal cavity. The nasal tracker (NT) consists of the EM coil array of the AxiEM tracker plugged into a nasal tamponade, which is then inserted into the inferior nasal meatus. Initially, a proof-of-concept study was performed on two cadaveric skull bases. The stability of the NT was assessed in simulated surgical situations, for example, prone, supine, and lateral patient positioning and skin traction. A deviation ≤ 2 mm was judged sufficiently accurate for clinical trial. Thus, a feasibility study was performed in the clinical setting. Positional changes of the NT and a standard skin-adhesive tracker (ST) relative to a ground-truth reference tracker were recorded throughout routine surgical procedures. The accuracy of the NT and ST was compared at different stages of surgery. Ex vivo, the NT proved to be highly stable in all simulated surgical situ...Continue Reading

Citations

Nov 19, 2021·International Journal of Computer Assisted Radiology and Surgery·Milovan RegodićWolfgang Freysinger

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