CN110755156A - Titanium nail registration device and method for cochlear implant navigation surgery - Google Patents
Titanium nail registration device and method for cochlear implant navigation surgery Download PDFInfo
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- CN110755156A CN110755156A CN201911110699.6A CN201911110699A CN110755156A CN 110755156 A CN110755156 A CN 110755156A CN 201911110699 A CN201911110699 A CN 201911110699A CN 110755156 A CN110755156 A CN 110755156A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36036—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of the outer, middle or inner ear
- A61N1/36038—Cochlear stimulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2065—Tracking using image or pattern recognition
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Abstract
The invention relates to a navigation registration system, in particular to a titanium nail registration device and method for cochlear implant navigation surgery. A titanium nail registration device for a cochlear implant navigation operation is characterized in that the head of a patient is fixed on a head frame, special optical mark points are fixed on the head frame and a tail end operation tool, and 4 titanium nails are implanted on the rear side of an auricle before an operation so as to be matched with a probe. The invention also provides a titanium nail registration method for the cochlear implant navigation operation, which comprises the steps of scanning the head CT before an operation, and three-dimensionally reconstructing key parts such as titanium nails, cochlea and the like; sequentially pointing the probe to each titanium nail by taking the headstock as a reference system, and acquiring coordinates of marking points on the probe and the headstock through a binocular tracking sensor; calculating the coordinate transformation relation between the titanium nail and the head frame to realize the registration from the image space to the operation space; and reading the position and posture of the optical mark point on the surgical tool in real time to realize navigation. The device and the method enable the operation to be more visual, are convenient to operate, improve the operation precision and reduce the operation risk.
Description
Technical Field
The invention relates to a titanium nail registration device and method for a cochlear implant navigation operation.
Background
The cochlea is a component of the peripheral auditory system, and the core of the cochlea is an organ for transmitting auditory sense to the organ of corti, which converts sound signals from the middle ear into corresponding nerve electrical signals to be delivered to the central auditory system of the brain for further processing. The most pathological bases of sensorineural deafness are derived from saccades or functional defects of hair cells, and the artificial cochlea can convert sound into an electric signal in a certain coding form by an in-vitro language processor and directly excite auditory nerves by an electrode system implanted in a human body to restore or reconstruct the auditory function of a deaf person.
The essence of the cochlear implant operation is that the inside of the cochlear implant is partially placed under the skin behind the ear and outside the skull and fixed. The operation has extremely high requirements on an executor, the electrode needs to be deeply inserted into the scala tympani under the condition of not damaging the electrode, the electrode and an implant body can not be damaged, and meanwhile, the structures around the electrode and the implant body, such as the scalp, the external auditory canal, the tympanic membrane, the facial nerve and the like, can not be damaged, so that certain risks exist in the operation process, such as damage to the vestibular system or the facial nerve and the like, and a better solution is not found at present. With the development of technologies such as computer and vision, the minimally invasive surgery under navigation is gradually popularized, so that not only is the surgery wound reduced, but also the surgery precision is improved. Two of the most critical problems in performing navigated surgery are the registration and real-time navigation of the organ tissue in the surgical field and the surgical equipment working space.
Disclosure of Invention
Technical problem to be solved
The invention aims to provide a titanium nail registration device and a titanium nail registration method for cochlear implant navigation surgery, which are used for positioning and navigating surgical tools in the cochlear implant surgery process and assisting doctors to improve the surgery precision and reduce the surgery risk.
(II) technical scheme
In order to achieve the above purpose, the present invention provides a titanium nail registration device and method for cochlear implant navigation surgery, which comprises the following steps:
s1, fixing the head (2) of a patient with a head frame (6), and implanting 4 titanium nails (3) behind an auricle on the affected side;
s2, performing head CT scanning, and three-dimensionally reconstructing relevant tissues such as the titanium nails (3), the external auditory meatus, the cochlear and the like to obtain respective coordinates in an image space;
s3, sequentially connecting the probe (4) with the top of each titanium nail (3), and respectively acquiring the space coordinates of the probe (4) and the mark points (5) on the headstock (6) by using a binocular tracking sensor (7);
s4, calculating the space coordinate of the connected titanium nail (3) under the head frame (6) reference system according to the space coordinate of the probe (4) under the head frame (6) reference system;
s5, calculating the space coordinates of tissues such as the cochlea and the like in the head frame (6) reference system according to the coordinates of the titanium nail (3) in the head frame (6) reference system and the coordinates of the titanium nail (3) and each tissue of the cochlea in the image space;
s6, performing cochlear implant surgery, and positioning and navigating the surgical tool in real time by tracking the mark points (5) on the surgical tool by using the binocular tracking sensor (7).
According to the invention, the fixation in step S1 means that the head (2) of the patient and the head frame (6) are kept relatively still all the time during the operation, and the mark point (5) on the head frame (6) can be identified by the binocular tracking sensor (7); the implanted titanium nail (3) is a special screw which is made of titanium alloy material and is provided with a groove at the top.
According to the invention, in step S2, the three-dimensional reconstruction of the CT image means that a three-dimensional model and spatial coordinates of the titanium nail (3), the cochlea and the surrounding tissues of the patient are reconstructed according to the sequence CT image, so that the spatial position relationship of the tissues such as the titanium nail (3) and the cochlea is obtained.
According to the invention, in step S3, the tail end (402) of the probe can be inserted into the groove at the top of each titanium nail (3) in sequence, and the mark point (5) on the head end (401) of the probe can be identified by the binocular tracking sensor (7); the binocular tracking sensor (7) can obtain the space coordinates of the probe (4) and the mark points (5) on the headstock (6).
According to the invention, in step S4, a spatial coordinate system of the head frame (6) is constructed, and according to the mechanical size of the probe (4), the coordinates of the probe (4) and the head frame (6) under the binocular tracking sensor (7) calculate the spatial coordinates of the titanium nail under the head frame (6) reference system.
According to the invention, in step S5, according to the spatial position relationship between the titanium nail (3) and the cochlea and the surrounding tissues obtained in S2 and the spatial coordinates of the titanium nail (3) in the frame of reference of the head frame (6) obtained in S4, the spatial coordinates and the position of the cochlea and the surrounding tissues of the patient in the frame of reference of the head frame (6) can be calculated, and the registration is finished.
According to the invention, in step S6, the surgical tool is provided with a mark point (5), during the operation, the instrument is positioned by a binocular tracking sensor (7), and the terminal coordinates of the instrument are converted into the head frame (6) reference system by combining the physical size of the surgical tool, so that the instrument navigation during the operation is realized.
(III) advantageous effects
The titanium nail registration device and the method for the cochlear implant navigation operation are unified to a reference coordinate system according to the marking points of the probe and the head frame, the titanium nails and the CT images of the cochlear implant of the patient, can accurately position the operation tool, and perform navigation according to preoperative planning, are convenient for the operation of a doctor, improve the accuracy of the operation, and reduce the operation risk and possible damage to the patient.
Drawings
FIG. 1 is a schematic view of a titanium nail registration device and method for cochlear implant navigation surgery provided by the present invention;
FIG. 2 is a schematic view of a headgear and titanium nail apparatus;
FIG. 3 is a schematic view of a headgear configuration;
FIG. 4 is a schematic structural view of a titanium nail;
FIG. 5 is a schematic view of the probe and titanium pin in combination;
in the figure, the components are labeled as follows:
1-operating bed 2-patient 3-titanium nail 4-probe
5-mark point 6-headstock 7-binocular sensor 601-right support
602-left support 603-spring clamp 401-probe head end 402-probe tail end
Detailed Description
The following describes in detail a titanium nail registration apparatus and method for cochlear implant navigation according to the present invention with reference to the following embodiments and the accompanying drawings, but the scope of the present invention is not limited to the following embodiments.
Referring to fig. 1 and 2, 4 titanium nails are implanted in the auricle at the operation side of the patient before operation, CT scan is performed on the head of the patient, a computer is used for three-dimensional reconstruction of the titanium nails (3), the cochlea and the surrounding tissues, respective coordinates and relative position relations of the titanium nails and the cochlea are obtained in an image space, and planning of a three-dimensional operation path is performed according to operation requirements.
Referring to fig. 3, during operation, a human body (2) lies on the operating bed (1), the head part is placed on the side, and the side of the implanted titanium nail faces upwards; the spring clamp (603) of the head frame (6) is clamped on the operating table (1), the left support (602) and the right support (601) are sequentially adjusted to clamp the head of a human body, and the stability of the head of the human body during an operation is ensured.
Referring to fig. 4 and 5, the tail end (402) of the probe can be sequentially inserted into the grooves at the top of each titanium nail (3), and the mark point (5) on the head end (401) of the probe can be identified by the binocular tracking sensor (7); the binocular tracking sensor (7) can obtain the space coordinates of the probe (4) and the mark points (5) on the headstock (6).
And (3) constructing a spatial coordinate system of the head frame (6), and calculating the spatial coordinates of the titanium nail in a head frame (6) reference system according to the mechanical size of the probe (4) and the coordinates of the probe (4) and the head frame (6) under a binocular tracking sensor (7).
According to the spatial position relation between the titanium nail (3) and the cochlea and the surrounding tissues obtained in the image segmentation and the spatial coordinates of the titanium nail (3) under the head frame (6) reference system obtained in the probe acquisition, the spatial coordinates and the position of the cochlea and the surrounding tissues of the patient under the head frame (6) reference system can be calculated, and the registration is finished.
The artificial cochlea implanting operation is carried out, the marking points (5) are arranged on the operation tool, in the operation process, the instrument is positioned through the binocular tracking sensor (7), the terminal coordinate of the instrument is converted into the head frame (6) reference system by combining the physical size of the operation tool, and the instrument navigation in the operation process is realized.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those skilled in the art; the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.
Claims (7)
1. A titanium nail registration device and method for cochlear prosthesis navigation surgery comprises the following steps:
s1, fixing the head (2) of a patient with a head frame (6), and implanting 4 titanium nails (3) behind an auricle on the affected side;
s2, performing head CT scanning, and three-dimensionally reconstructing relevant tissues such as the titanium nails (3), the external auditory meatus, the cochlear and the like to obtain respective coordinates in an image space;
s3, sequentially connecting the probe (4) with the top of each titanium nail (3), and respectively acquiring the space coordinates of the probe (4) and the mark points (5) on the headstock (6) by using a binocular tracking sensor (7);
s4, calculating the space coordinate of the connected titanium nail (3) under the head frame (6) reference system according to the space coordinate of the probe (4) under the head frame (6) reference system;
s5, calculating the space coordinates of tissues such as the cochlea and the like in the head frame (6) reference system according to the coordinates of the titanium nail (3) in the head frame (6) reference system and the coordinates of the titanium nail (3) and each tissue of the cochlea in the image space;
s6, performing cochlear implant surgery, and positioning and navigating the surgical tool in real time by tracking the mark points (5) on the surgical tool by using the binocular tracking sensor (7).
2. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
the fixation in the step S1 means that the head (2) and the head frame (6) of the patient are kept relatively still all the time in the operation process, and the mark point (5) on the head frame (6) can be identified by the binocular tracking sensor (7); the implanted titanium nail (3) is a special screw which is made of titanium alloy material and is provided with a groove at the top.
3. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
in step S2, the three-dimensional reconstruction of the CT image means reconstructing a three-dimensional model and spatial coordinates of the titanium nail (3), the cochlea and surrounding tissues of the patient according to the sequence CT image, so as to obtain a spatial position relationship of the tissues such as the titanium nail (3) and the cochlea.
4. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
in the step S3, the tail ends of the probes (4) can be sequentially inserted into the grooves at the tops of the titanium nails (3), and the mark points (5) on the probes (4) can be identified by the binocular tracking sensor (7); the binocular tracking sensor (7) can obtain the space coordinates of the probe (4) and the mark points (5) on the headstock (6).
5. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
in the step S4, a spatial coordinate system of the head frame (6) is constructed, and spatial coordinates of the titanium nail in the head frame (6) reference system are calculated according to the mechanical size of the probe (4) and coordinates of the probe (4) and the head frame (6) under the binocular tracking sensor (7).
6. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
in the step S5, according to the spatial position relationship between the titanium nail (3) and the cochlea and the surrounding tissues obtained in S2 and the spatial coordinates of the titanium nail (3) in the frame of reference of the head frame (6) obtained in S4, the spatial coordinates and the position of the cochlea and the surrounding tissues of the patient in the frame of reference of the head frame (6) can be calculated, and the registration is finished.
7. A titanium nail registration device and method for cochlear implant navigation surgery as claimed in one aspect, wherein:
in the step S6, the surgical tool is provided with a mark point (5), in the surgical process, the instrument is positioned through the binocular tracking sensor (7), and the terminal coordinate of the instrument is converted into the reference system of the head frame (6) by combining the physical size of the surgical tool, so that the instrument navigation in the surgical process is realized.
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CN201911110699.6A CN110755156A (en) | 2019-11-14 | 2019-11-14 | Titanium nail registration device and method for cochlear implant navigation surgery |
CN202010880144.6A CN111803212B (en) | 2019-11-14 | 2020-08-27 | Titanium nail registration system and method for cochlear prosthesis navigation surgery |
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Cited By (5)
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CN112120756A (en) * | 2020-08-24 | 2020-12-25 | 中国计量大学 | Auxiliary positioning device for cochlear implant drilling operation and implementation method thereof |
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CN112353450A (en) * | 2020-10-27 | 2021-02-12 | 武汉中科医疗科技工业技术研究院有限公司 | Bone nail registration auxiliary mechanism, bone nail registration system and method |
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CN112754656B (en) * | 2021-01-12 | 2022-05-17 | 上海交通大学 | Artificial cochlea implantation operation robot and auxiliary method and auxiliary system thereof |
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WO1997032629A1 (en) * | 1996-03-06 | 1997-09-12 | Advanced Bionics Corporation | Magnetless implantable stimulator and external transmitter and implant tools for aligning same |
EP1874183A4 (en) * | 2005-04-29 | 2010-06-09 | Univ Vanderbilt | System and methods of using image-guidance for providing an access to a cochlear of a living subject |
CN103330616B (en) * | 2013-07-02 | 2015-05-27 | 北京大学第三医院 | Artificial cochlea implanting operation system based on computer vision |
CN105658167B (en) * | 2013-08-23 | 2018-05-04 | 斯瑞克欧洲控股I公司 | Computer for being determined to the coordinate conversion for surgical navigational realizes technology |
CN106037964B (en) * | 2016-08-16 | 2019-07-16 | 苏州迪凯尔医疗科技有限公司 | Medical image registration method based on moulage |
US11185693B2 (en) * | 2018-02-07 | 2021-11-30 | Medtronic Xomed, Inc. | Cochlear implant localization system |
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CN112641512A (en) * | 2020-12-08 | 2021-04-13 | 北京信息科技大学 | Spatial registration method applied to surgical robot front planning |
CN112641512B (en) * | 2020-12-08 | 2023-11-10 | 北京信息科技大学 | Spatial registration method applied to preoperative robot planning |
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