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Further Validity Evidence for Patient-Specific Virtual Reality Temporal Bone Surgical Simulation

Andersen, Steven Arild Wuyts ; Hittle, Brad ; Värendh, Maria LU ; Lee, Julian ; Varadarajan, Varun ; Powell, Kimerly A. and Wiet, Gregory J. (2023) In Laryngoscope
Abstract

Objective: Patient-specific virtual reality (VR) simulation of cochlear implant (CI) surgery potentially enables preoperative rehearsal and planning. We aim to gather supporting validity evidence for patient-specific simulation through the analysis of virtual performance and comparison with postoperative imaging. Methods: Prospective, multi-institutional study. Pre- and postoperative cone-beam CT scans of CI surgical patients were obtained and processed for patient-specific VR simulation. The virtual performances of five trainees and four attendings were recorded and (1) compared with volumes removed during actual surgery as determined in postoperative imaging, and (2) assessed using the Copenhagen Cochlear Implant Surgery Assessment... (More)

Objective: Patient-specific virtual reality (VR) simulation of cochlear implant (CI) surgery potentially enables preoperative rehearsal and planning. We aim to gather supporting validity evidence for patient-specific simulation through the analysis of virtual performance and comparison with postoperative imaging. Methods: Prospective, multi-institutional study. Pre- and postoperative cone-beam CT scans of CI surgical patients were obtained and processed for patient-specific VR simulation. The virtual performances of five trainees and four attendings were recorded and (1) compared with volumes removed during actual surgery as determined in postoperative imaging, and (2) assessed using the Copenhagen Cochlear Implant Surgery Assessment Tool (CISAT) by two blinded raters. The volumes compared were cortical mastoidectomy, facial recess, and round window (RW) cochleostomy as well as violation of the facial nerve and chorda. Results: Trainees drilled more volume in the cortical mastoidectomy and facial recess, whereas attendings drilled more volume for the RW cochleostomy and made more violations. Except for the cochleostomy, attendings removed volumes closer to that determined in postoperative imaging. Trainees achieved a higher CISAT performance score compared with attendings (22.0 vs. 18.4 points) most likely due to lack of certain visual cues. Conclusion: We found that there were differences in performance of trainees and attendings in patient-specific VR simulation of CI surgery as assessed by raters and in comparison with actual drilled volumes. The presented approach of volume comparison is novel and might be used for further validation of patient-specific VR simulation before clinical implementation for preoperative rehearsal in temporal bone surgery. Level of Evidence: n/a Laryngoscope, 2023.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
cochlear implantation surgery, mastoidectomy, patient-specific simulation, performance assessment, training, virtual reality simulation
in
Laryngoscope
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:37650640
  • scopus:85169471935
ISSN
0023-852X
DOI
10.1002/lary.31016
language
English
LU publication?
yes
id
c43862a8-7e6d-4199-b45b-0e6155c4f896
date added to LUP
2023-11-10 12:48:40
date last changed
2024-04-22 04:13:40
@article{c43862a8-7e6d-4199-b45b-0e6155c4f896,
  abstract     = {{<p>Objective: Patient-specific virtual reality (VR) simulation of cochlear implant (CI) surgery potentially enables preoperative rehearsal and planning. We aim to gather supporting validity evidence for patient-specific simulation through the analysis of virtual performance and comparison with postoperative imaging. Methods: Prospective, multi-institutional study. Pre- and postoperative cone-beam CT scans of CI surgical patients were obtained and processed for patient-specific VR simulation. The virtual performances of five trainees and four attendings were recorded and (1) compared with volumes removed during actual surgery as determined in postoperative imaging, and (2) assessed using the Copenhagen Cochlear Implant Surgery Assessment Tool (CISAT) by two blinded raters. The volumes compared were cortical mastoidectomy, facial recess, and round window (RW) cochleostomy as well as violation of the facial nerve and chorda. Results: Trainees drilled more volume in the cortical mastoidectomy and facial recess, whereas attendings drilled more volume for the RW cochleostomy and made more violations. Except for the cochleostomy, attendings removed volumes closer to that determined in postoperative imaging. Trainees achieved a higher CISAT performance score compared with attendings (22.0 vs. 18.4 points) most likely due to lack of certain visual cues. Conclusion: We found that there were differences in performance of trainees and attendings in patient-specific VR simulation of CI surgery as assessed by raters and in comparison with actual drilled volumes. The presented approach of volume comparison is novel and might be used for further validation of patient-specific VR simulation before clinical implementation for preoperative rehearsal in temporal bone surgery. Level of Evidence: n/a Laryngoscope, 2023.</p>}},
  author       = {{Andersen, Steven Arild Wuyts and Hittle, Brad and Värendh, Maria and Lee, Julian and Varadarajan, Varun and Powell, Kimerly A. and Wiet, Gregory J.}},
  issn         = {{0023-852X}},
  keywords     = {{cochlear implantation surgery; mastoidectomy; patient-specific simulation; performance assessment; training; virtual reality simulation}},
  language     = {{eng}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Laryngoscope}},
  title        = {{Further Validity Evidence for Patient-Specific Virtual Reality Temporal Bone Surgical Simulation}},
  url          = {{http://dx.doi.org/10.1002/lary.31016}},
  doi          = {{10.1002/lary.31016}},
  year         = {{2023}},
}