以颅骨体表骨性结构为配准标定点的方法在鼻内镜导航手术中的应用  

Application of skull bone markers registration in imaging guidance system guided endoscopic sinus and nasal skull base surgery

作　　者：王彦君[1] 刘启桐[2] 杜晶艳[1] 刘锦峰[1] 王宁宇[1] WANG Yanjun;LIU Qitong;DU Jingyan;LIU Jinfeng;WANG Ningyu(Department of Otolaryngology Head and Neck Surgery,Capital Medical University,Beijing,100020,China;Department of Radiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing,100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科,北京100020 [2]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中国耳鼻咽喉头颈外科》2021年第8期472-475,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨颅骨体表骨性结构作为配准标定点的方法在鼻内镜导航手术中的应用价值。方法回顾分析2017年5月~2018年11月行鼻内镜手术患者。骨性标志组以额骨颧突、中切牙根或鼻骨为配准标定点,对照组以外眦和人中软组织为配准标定点。分析两组导航误差、配准时间、配准标定点选择次数。结果骨性标志组11例,软组织组9例;骨性标志组(中位数1 mm,四分位数间距0.5 mm)的导航误差小于面部软组织组(中位数2 mm,四分位数间距0.5 mm),差异具有显著性(Z=3.51,P<0.05);骨性标志组(中位数3.5 min,四分位数间距1 min)的导航配准时间小于面部软组织组(中位数7.5 min,四分位数间距1.5 min),差异具有显著性(Z=3.48,P<0.05);骨性标志组(中位数1次,四分位数间距1次)配准标定点选择次数少于面部软组织组(中位数3次,四分位数间距1次),差异具有显著性(Z=3.76,P<0.05)。相对于颅面软组织组,颅面骨性标志组在可操作性、误差大小和耗时方面更有优势。结论使用颅骨体表骨性标志做为配准标定点的方法可操作性强、精确度高。OBJECTIVE To explore the value of skull surface bone markers as registration points in imaging guidance system(IGS)of endoscopic sinus surgery.METHODS Retrospective analysis of patients who underwent endoscopic sinus surgery guided by IGS from May 2017 to November 2018 were performed.The bilateral frontozygomatic process,root of middle incisor or nasal bone were used as the registration pointsin skull bone landmarks group,while in the control group,thesoft tissueoflateral canthus and human middle were used as the registration points.RESULTS Eleven patients used skull bone land markers as registration points in the experimental group,and 9 patients used facial soft tissue as registration points in the control group.The navigation error of skull bone landmarks group(median 1 mm,interquartile 0.5 mm)was smaller than that of facial soft tissue group(median 2 mm,interquartile 0.5 mm)(Z=3.51,P<0.05).The registration time of skull bone landmarks group(median 3.5 min,interquartile interval 1 min)was shorter than that of facial soft tissue group(median 7.5 min,interquartile interval 1.5 min)(Z=3.48,P<0.05).The skull bone landmarks group(median:once,interquartile interval:once)had less registration points than the facial soft tissue group(median:three times,interquartile interval:once)(Z=3.76,P<0.05).Compared with facial soft tissue group,skull bone landmarks group has more advantages in operability,error size and operational time.CONCLUSION The registration method using skull bone markers as registration point is more accurate and manipulable for imaging guided endoscopic sinus surgery.

关 键 词：内窥镜检查 影像导航 图像配准 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]