CN112120756B - Auxiliary positioning device for cochlear implant drilling operation and implementation method thereof - Google Patents
Auxiliary positioning device for cochlear implant drilling operation and implementation method thereof Download PDFInfo
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- CN112120756B CN112120756B CN202010856180.9A CN202010856180A CN112120756B CN 112120756 B CN112120756 B CN 112120756B CN 202010856180 A CN202010856180 A CN 202010856180A CN 112120756 B CN112120756 B CN 112120756B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
Abstract
The invention relates to the technical field of cochlear implant drilling operations, in particular to an auxiliary positioning device for cochlear implant drilling operations and an implementation method thereof, wherein the auxiliary positioning device comprises: the titanium ball bearing comprises an outer ring, an inner ring and titanium balls, wherein the inner ring is sleeved in the outer ring, and a plurality of titanium balls are circumferentially distributed on the outer circle of the outer ring; the invention realizes that more reference mark points are provided on a very small wound surface, the injury of the temporal bone is reduced, the spatial position and the angle of an implantation point are accurately calculated, and the secondary injury is reduced while the precision is ensured.
Description
Technical Field
The invention relates to the technical field of cochlear implant drilling operations, in particular to an auxiliary positioning device for cochlear implant drilling operations and an implementation method thereof.
Background
The artificial cochlea is an electronic device, and the external speech processor converts the sound into an electric signal in a certain coding form, and directly excites the auditory nerve through the motor system implanted in the human body to recover, improve and reconstruct the auditory function of the deaf. The cochlear implant is the most successful biomedical engineering device at present, and the cochlear implant implantation operation is already used as a conventional method for treating moderate to full deafness, so that the cochlear implant can be widely applied to normal cochlea, and even has good treatment effect on deformed cochlea.
Cochlear implant electrode implantation is an elaborate and complex operation, and especially the traditional electrode implantation operation has extremely high requirements on the experience and the operation capability of doctors. In recent years, the implantation operation mode of the artificial cochlea has obvious progress, and a minimally invasive artificial cochlea drilling operation is further provided. The traditional cochlear implant surgery is to make an electrode implant channel by opening the mastoid surface to expose the round implant window, while the cochlear implant drilling surgery is to drill a channel directly from the temporal bone of the human body to the scala tympani of the cochlea. The artificial cochlea drilling operation can be used for better protecting the residual hearing of the postoperative patient.
Due to the requirement of the cochlear implant drilling operation, a path from the outside of the temporal bone to the scala tympani of the cochlea needs to be obtained, and due to the existence of important nerve tissue structures such as the facial nerve, the tympanum and the like in the path, the temporal bone of the patient needs to be calibrated to obtain a structural view in the ear of the patient. The surgical doctor needs to realize the visualization of external structure to patient's registration mark point on the temporal bone in the operation, and basic way is to lift mastoid surface to implant at least four titanium nails, the depth respectively two, through temporal bone data after high accuracy CT scan registration, obtain the relative position of titanium nail and middle ear inner tissue structure, only need judge the position of titanium nail in the operation, just can obtain the spatial position of the inner tissue structure of ear.
When the cochlear implant drilling operation is performed, the initial position of a drilling point, namely a drilling angle, needs to be judged firstly, and the path of the drilling point passing through a face recess is judged by using a computer through an image after high-precision CT reconstruction, and then the drilling point is mapped to a calibration point (titanium nail) plane in a straight line mode. The surgeon drills the channel through the visible titanium nail by calculating the relative position of the initial point of the drilling hole and the titanium nail. Due to the technical difficulty of the calibration of the bone titanium nail and the randomness of each calibration, two influences can be caused: firstly, the spatial position of the titanium nail mark is too single, the depth information cannot be fed back well, and the calculation error causes the drilling path to damage other tissue structures; secondly, the excessive calibration points inevitably cause secondary damage to the temporal bone.
How to accurately register the calibration points on the temporal bone and reduce secondary damage brought by calibration and a calculation mode for accurately calculating the markers and the initial point of the drilled hole is very important. When the existing medical means is used for the cochlear implant drilling operation, titanium nails are used as markers in the positioning and registering preparation stage, and marker points need to be implanted on tissues with different depths, so that the damage to temporal bones is large. When the existing artificial cochlea drilling operation is positioned, the initial drilling point is calculated through the titanium nail, and the accurate quantification of the initial drilling point is not realized.
Accordingly, there is a need for improvements in the art.
Disclosure of Invention
In order to solve the technical problems, the invention provides an auxiliary positioning device for cochlear implant drilling surgery, which can accurately calculate the spatial position and angle of an implantation point and reduce temporal bone injury, and an implementation method thereof.
The technical scheme of the invention is as follows:
an auxiliary positioning device for a drilling operation of an artificial cochlea comprises an outer ring, an inner ring and titanium balls, wherein the inner ring is sleeved in the outer ring, and a plurality of titanium balls are circumferentially distributed on the outer circle of the outer ring;
the color information is the most easily obtained characteristic in the visual registration process, the center coordinate of the inner ring is easily obtained through an image due to the color difference formed by the outer ring and the inner ring, and the position of the implantation point is calculated through the mark points on the inner ring through the center coordinate, the size of the auxiliary positioning device for the cochlear implant drilling operation and the first tip, the second tip and the third tip on the inner ring.
Preferably, the method comprises the following steps: the outer ring is provided with a plurality of round holes along the circumferential surface;
the spherical surface of the titanium ball is fixedly connected with a cylinder which is sleeved in a round hole on the circumferential surface of the outer circular ring;
the titanium ball is used for replacing a titanium nail in a traditional implantation operation, plays a role of a marker in CT scanning reconstruction, has more quantity compared with the implanted titanium nail, and can calculate the obtained drilling data more accurately.
Preferably, the method comprises the following steps: 5 titanium balls are circumferentially distributed on the excircle of the outer ring, 4 titanium balls are uniformly distributed on the upper half circle, and 1 titanium ball is arranged in the middle of the lower half circle;
the 5 titanium balls are used for forming a multi-side half cycle and a few-side half cycle in the distribution of the 5 titanium balls, the titanium balls in the few-side half cycle are just opposite to the first tip, and the rest titanium balls are distributed at an interval of 30 degrees with the second tip and the third tip, so that the small-number one-side half cycle can be found through the concentration degree of the titanium balls when positioning is carried out in visual image processing, and the position of the first tip can be found more quickly.
Preferably, the method comprises the following steps: 3 fixing holes are uniformly formed in the circumferential direction of the side face of the outer ring;
the fixing hole is used for realizing the easy installation of the auxiliary positioning device for the cochlear implant drilling operation, and the auxiliary positioning device for the cochlear implant drilling operation can be fixed on the temporal bone only by three wounds, so that the damage to the temporal bone in the operation process is reduced.
Preferably, the method comprises the following steps: and a groove is arranged on the inner circular surface of the front side surface of the outer ring.
Preferably, the method comprises the following steps: the length of the groove along the axial direction of the outer ring is smaller than the thickness between two side surfaces of the outer ring.
The outer surface of the front side surface of the inner ring is provided with a boss with the size corresponding to that of the groove;
the boss is arranged in the groove;
the boss and the groove are used for preventing the relative rotation between the axis of the outer ring and the axis of the inner ring, and preventing the relative sliding of the outer ring and the inner ring along the axis direction;
the planes on the two sides of the outer circular ring are flush with the planes on the two sides of the inner circular ring.
Preferably, the method comprises the following steps: the inner surface of the inner ring is uniformly distributed with a first tip, a second tip and a third tip along the circumferential direction.
Preferably, the method comprises the following steps: the tips of the first tip, the second tip and the third tip face to the axis of the inner circular ring;
the first tip corresponds to 1 titanium ball arranged at the middle position of the lower half circle in the circumferential direction.
Preferably, the method comprises the following steps: the positions of the first tip, the second tip and the third tip are respectively provided with a through hole;
the positions of the first tip, the second tip and the third tip are respectively provided with a through hole, the effect is that the relative positions of the first tip, the second tip and the third tip are determined to be difficult in the image recognition process, the positions of the first tip, the second tip and the third tip are respectively provided with a through hole, the recognition degree of the through holes on the image is higher and more visual, the positions of the first tip, the second tip and the third tip are obtained by obtaining the positions of the through holes in the image processing, and the positions of the first tip, the second tip and the third tip in the image can be calculated and calculated by using the positions of the round hole and the titanium ball.
An implementation method of an auxiliary positioning device for a cochlear implant drilling operation is carried out according to the following steps:
step one, facing the front side surface of the auxiliary positioning device for the cochlear implant drilling operation, which is provided with a groove and a convex groove, to a temporal bone, and fixing the auxiliary positioning device for the cochlear implant drilling operation on the temporal bone by using a titanium nail;
secondly, performing visual registration of the temporal bone, and calculating the relative position of the invisible tissues in the middle ear of the human eye according to the position of the visible marker;
the temporal bone carries the auxiliary positioning device of the cochlear implant drilling operation to carry out high-precision CT scanning;
reconstructing CT scanning information through medical reconstruction software, and obtaining the relative position relation between tissues in the ear and the relative position relation between the tissues and the titanium ball by taking the titanium ball as a marker;
planning a drilling channel which meets the drilling space and safety through a face recess in the CT reconstruction image according to the space requirement of the cochlear implant drilling operation, and determining the intersection point of the drilling channel and the external side surface of the cochlear implant drilling operation auxiliary positioning device in the operation as the position of the initial drilling point;
step five, the surgical robot defines a vector starting point, and records the position vector of the drilling starting point Pd through the positions of a first tip and a second tip on the auxiliary positioning device for cochlear implant drilling surgery, wherein the calculation formula is as follows:
b ═ c' + h formula 3
Pd ═ P1+ b formula 4
Wherein, b: a vector connecting the P1 and Pd points; h: the high vector of triangle PdP1P2 through Pd points with P1P 2; c': a vector connecting P1 and the h drop; α: a vector connecting the P2 and Pd points; c: a vector connecting the P1 and P2 points; s: half perimeter of triangle PdP1P 2; pd: a position vector of an initial point of drilling; p1: a position vector of a side apex of the first tip; p2: the position vector of the same lateral vertex of the second tip as point P1;
the position of the drilling initial point Pd is recorded through the positions of the first tip and the second tip on the auxiliary positioning device for the cochlear implant drilling operation, the effect is that the positions of the first tip, the second tip and the third tip in a CT reconstruction image are not visible, and in the operation of the surgical robot, the surgical robot can accurately detect the first tip, the second tip and the third tip by using image processing and perform the operation according to the position coordinates of the first tip, the second tip and the third tip, so that the relation between the drilling initial point Pd and the first tip, the second tip and the third tip needs to be recorded firstly.
Formula 4 is to obtain the vector coordinates of Pd through P1 and b, but Pd obtained in the image is the visual coordinates, which may be collected in any direction, and only the absolute distance between Pd and P1, that is, the modulus of b, can be obtained, but the direction of b cannot be obtained, and the vector of b needs to be calculated by using formula 3, and c' and h in formula 3 have only the direction in the auxiliary positioning device for cochlear drilling surgery, so formula 1 and formula 2 are needed to calculate their moduli;
the height of the triangle PdP1P2, i.e. the length of h, can be calculated by a combination of the Heron formula and the formula for calculating the triangle area from the triangle height;
in the CT reconstruction model, the distance of b can be easily obtained, but the direction of the b is unknown, and the b vector is calculated by the sum of the vectors c' and h;
the two tips of P1 and P2 and Pd form a triangle, and the position vector of Pd is calculated by adding the position vector of P1 and the b vector;
and step six, detecting the structure of the inner ring by the surgical robot through image processing, finding the positions of the first tip, the second tip and the third tip on the inner ring, determining the position of P1, performing matrix conversion by using the position vector data of the initial drilling point Pd calculated in the step five, and operating according to the direction of the drilling channel when the drill bit runs to the position of the initial drilling point.
The invention relates to an auxiliary positioning device for a cochlear implant drilling operation and an implementation method thereof, which have the technical advantages that: the method has the advantages that more reference mark points are provided on a very small wound surface, the damage to the temporal bone is reduced, the spatial position and the angle of an implantation point are accurately calculated, and the secondary damage is reduced while the precision is ensured.
Drawings
The following describes embodiments of the present invention in further detail with reference to the accompanying drawings.
FIG. 1 is a front view of the apparatus of the present invention;
FIG. 2 is a perspective view of the device of the present invention;
FIG. 3 is an exploded schematic view of the apparatus of the present invention;
FIG. 4 is a schematic view of the initial point calculation for drilling of the apparatus of the present invention;
in the figure: an outer ring 10; a groove 11; a fixing hole 12; an inner ring 20, a titanium ball 30; a first tip 41; a second tip 42; a third tip 43; a boss 44.
Detailed Description
The invention will be further described with reference to specific examples, but the scope of the invention is not limited thereto.
As shown in fig. 1 to 4, the auxiliary positioning device for cochlear implant drilling operation and the implementation method thereof provided by the invention,
the titanium ball bearing comprises an outer ring 10, an inner ring 20 and titanium balls 30, wherein the inner ring 20 is sleeved in the outer ring 10, and the plurality of titanium balls 30 are circumferentially distributed on the outer circle of the outer ring 10.
The outer ring 10 is provided with a plurality of round holes along the circumferential surface;
the spherical surface of the titanium ball 30 is fixedly connected with a cylinder, and the cylinder is sleeved in a circular hole on the circumferential surface of the outer ring 10.
5 titanium balls 30 are circumferentially distributed on the outer circle of the outer ring 10, 4 titanium balls 30 are uniformly distributed on the upper half circle, and 1 titanium ball 30 is arranged in the middle of the lower half circle.
The side surface of the outer ring 10 is evenly provided with 3 fixing holes 12 along the circumferential direction.
The inner circular surface of the front side of the outer ring 10 is provided with a groove 11.
The length of the groove 11 along the axial direction of the outer ring 10 is less than the thickness between two side surfaces of the outer ring 10;
the outer surface of the front side surface of the inner ring 20 is provided with a boss 44 with the size corresponding to that of the groove 11;
the boss 44 is arranged in the groove 11;
the two side planes of the outer ring 10 are flush with the two side planes of the inner ring 20.
The inner surface of the inner ring 20 is evenly distributed with first tips 41, second tips 42 and third tips 43 in the circumferential direction.
The tips of the first tip 41, the second tip 42 and the third tip 43 face the axis of the inner ring 20;
the first tip 41 corresponds to 1 titanium ball 30 provided at the middle of the lower half circumference in the circumferential direction.
A through hole is provided at each of the first, second and third pointed ends 41, 42 and 43.
The implementation method of the auxiliary positioning device for the cochlear implant drilling operation comprises the following steps:
step one, facing the front side surface of the auxiliary positioning device for the cochlear implant drilling operation, which is provided with the groove 11 and the convex groove 44, to a temporal bone, and fixing the auxiliary positioning device for the cochlear implant drilling operation on the temporal bone by using titanium nails;
secondly, performing visual registration of the temporal bone, and performing high-precision CT scanning on the temporal bone with the auxiliary positioning device for the cochlear implant drilling operation;
reconstructing CT scanning information through medical reconstruction software, and obtaining the relative position relation between tissues in the ear and the titanium ball 30 by taking the titanium ball 30 as a marker;
planning a drilling channel which meets the drilling space and safety through a face recess in the CT reconstruction image according to the space requirement of the cochlear implant drilling operation, and determining the intersection point of the drilling channel and the external side surface of the cochlear implant drilling operation auxiliary positioning device in the operation as the position of the initial drilling point;
step five, the surgical robot defines a vector starting point, and records the position vector of the drilling starting point Pd through the positions of the first tip 41 and the second tip 42 on the cochlear implant drilling surgery auxiliary positioning device, wherein the calculation formula is as follows:
b ═ c' + h formula 3
Pd ═ P1+ b formula 4
Wherein, b: a vector connecting the P1 and Pd points; h: the high vector of triangle PdP1P2 through Pd points with P1P 2; c': a vector connecting P1 and the h drop; α: a vector connecting the P2 and Pd points; c: a vector connecting the P1 and P2 points; s: half perimeter of triangle PdP1P 2; pd: a position vector of an initial point of drilling; p1: a position vector of a side apex of the first tip 41; p2: the position vector of the same lateral vertex of the second tip 42 as point P1;
and step six, detecting the structure of the inner ring 20 by the surgical robot through image processing, finding the positions of the first tip 41, the second tip 42 and the third tip 43 in the inner ring 20 and determining the position of P1, and operating according to the direction of the drilling channel by using the position vector data of the drilling initial point Pd calculated in the step five and the drill bit running to the position of the drilling initial point.
Finally, it is also noted that the above-mentioned lists merely illustrate a few specific embodiments of the invention. It is obvious that the invention is not limited to the above embodiments, but that many variations are possible. All modifications which can be derived or suggested by a person skilled in the art from the disclosure of the present invention are to be considered within the scope of the invention.
Claims (3)
1. The utility model provides a supplementary positioner of artifical cochlear drilling operation which characterized in that: the titanium ball bearing comprises an outer ring (10), an inner ring (20) and titanium balls (30), wherein the inner ring (20) is sleeved in the outer ring (10), and the titanium balls (30) are circumferentially distributed on the outer circle of the outer ring (10);
the outer ring (10) is provided with a plurality of round holes along the circumferential surface;
the spherical surface of the titanium ball (30) is fixedly connected with a cylinder, and the cylinder is sleeved in a circular hole on the circumferential surface of the outer ring (10);
5 titanium balls (30) are circumferentially distributed on the excircle of the outer ring (10), 4 titanium balls (30) are uniformly distributed on the upper half circle, and 1 titanium ball (30) is arranged in the middle of the lower half circle;
3 fixing holes (12) are uniformly formed in the circumferential direction of the side face of the outer ring (10);
the inner circular surface of the front side surface of the outer circular ring (10) is provided with a groove (11);
the length of the groove (11) along the axial direction of the outer ring (10) is less than the thickness between two side surfaces of the outer ring (10);
the outer surface of the front side surface of the inner circular ring (20) is provided with a boss (44) which is equal to the size of the groove (11);
the lug boss (44) is arranged in the groove (11);
the planes on the two sides of the outer circular ring (10) are flush with the planes on the two sides of the inner circular ring (20);
the inner surface of the inner ring (20) is uniformly distributed with a first tip (41), a second tip (42) and a third tip (43) along the circumferential direction.
2. The auxiliary positioning device for cochlear implant drilling surgery according to claim 1, wherein: the tips of the first tip (41), the second tip (42) and the third tip (43) face the axis of the inner circular ring (20);
the first tip (41) corresponds to 1 titanium ball (30) arranged at the middle position of the lower half circle in the circumferential direction.
3. The auxiliary positioning device for cochlear implant drilling surgery according to claim 2, wherein: the first pointed end (41), the second pointed end (42) and the third pointed end (43) are respectively provided with a through hole.
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