Section: New Results

Stapedotomy

Stapedotomy is a challenging procedure of the middle ear microsurgery, since the surgeons is in direct contact with sensitive structures such as the ossicular chain. This procedures is taught and performed in the last phase of the surgical apprenticeship. To improve surgical teaching, we propose to use a virtual surgical simulator based on a finite element model of the middle ear. The static and dynamic behavior of the developed finite element model was successfully compared to published data on human temporal bones specimens. A semi-automatic algorithm was developed to perform a quick and accurate registration of our validated mechanical atlas to match the patient dataset. This method avoids a time-consuming work of manual segmentation, parameterization, and evaluation. A registration is obtained in less than 260 seconds with an accuracy close to a manual process and within the imagery resolution. The computation algorithms, allowing carving, deformation of soft and hard tissus, and collision response, are compatible with a real-time interactive simulation of a middle ear procedure. As a future work, we propose to investigate new robotized procedures of the middle ear surgery in order to develop new applications for the RobOtol device and to provide a training tool for the surgeons.

Figure 6. Simulation of the stapedotomy procedure.