Real time OCT navigated laser guided surgery setup on the lateral skull base

Real time OCT navigated laser guided surgery setup on the lateral skull base
Saleh Mohebbi1,2, Jakob Lexow1, Lüder Alexander Kahrs3, Alexander Fuchs3, Thomas Rau1, Sebastian Tauscher3, Marjan Mirsalehi1,2, Tobias Ortmaier3, Thomas Lenarz1, Omid Majdani1
1 Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
2 Brain and Spine Injury Research Center (BASIR),Tehran University of Medical Science, Tehran, Iran
3 Institute of Mechatronic Systems (IMES),Leibniz University Hannover, Hannover, Germany

Introduction: We proposed to set up an adaptive Optical coherence tomography (OCT) with a laser capability system and evaluate its applicability for simulating a robotic assisted surgical intervention, including planning, navigation, and processing on the lateral skull base. High resolution OCT view designed to navigate the laser beam.

Material and Methods: The setup involved the combination of an Er:YAG laser system connected to an OCT. In a cadaveric human head specimen, four metallic markers were placed on the edge of the middle cranial fossa craniotomy for registration and the sample was scanned with a CBCT scanner. After segmentation and Target point planning, the combined Er:YAG laser – OCT system was applied intraoperatively to merge the OCT and CT data and mark the IAC borders on the upper surface of the temporal bone by laser branding.

Result: The technical setup was feasible and laser marking of the approach canal to the IAC was performed with an overall accuracy of 300μm.

Conclusion: Three-dimensional OCT provides the necessary mapping of the anatomical structures at the surface of the temporal bone; which can be used for image guided Laser surgery in real time manner.