Abstract
BackgroundVirtual surgery may improve learning and provides an opportunity for pre-operative surgical rehearsal. We describe a novel haptic temporal bone simulator specifically developed for multicore processing and improved visual realism. A position locking algorithm for enhanced drill-bone interaction and haptic fidelity is further employed. The simulation construct is evaluated against cadaveric education.MethodsA voxel-based simulator was designed for multicore architecture employing Marching Cubes and Laplacian smoothing to perform real-time haptic and graphic rendering of virtual bone.Ten Otolaryngology trainees dissected a cadaveric temporal bone (CTB) followed by a virtual isomorphic haptic model (VM) based on derivative microCT data. Participants rated 1) physical characteristics, 2) specific anatomic constructs, 3) usefulness in skill development and 4) perceived educational value. The survey instrument employed a Likert scale (1-7).ResultsResidents were equivocal about the physical properties of the VM, as cortical (3.2 ± 2.0) and trabecular (2.8 ± 1.6) bone drilling character was appraised as dissimilar to CTB. Overall similarity to cadaveric training was moderate (3.5 ± 1.8). Residents generally felt the VM was beneficial in skill development, rating it highest for translabyrinthine skull-base approaches (5.2 ± 1.3). The VM was considered an effective (5.4 ± 1.5) and accurate (5.7 ± 1.4) training tool which should be integrated into resident education (5.5 ± 1.4). The VM was thought to improve performance (5.3 ± 1.8) and confidence (5.3 ± 1.9) and was highly rated for anatomic learning (6.1 ± 1.9).ConclusionStudy participants found the VM to be a beneficial and effective platform for learning temporal bone anatomy and surgical techniques. They identify some concern with limited physical realism likely owing to the haptic device interface. This study is the first to compare isomorphic simulation in education. This significantly removes possible confounding features as the haptic simulation was based on derivative imaging.
Highlights
Virtual surgery may improve learning and provides an opportunity for pre-operative surgical rehearsal
We describe the design of derivative haptic simulations from cadaveric temporal bone microCT data followed by experimental design, surgical resident preferences and perceptions of the model when compared directly to matched isomorphic cadaveric specimens
Residents were ambivalent about the physical similarity of the Virtual isomorphic haptic model (VM) as compared to Cadaveric temporal bone (CTB) (Table 1), rating it highest for its air cell system representation (5.4 ± 1.4)
Summary
Virtual surgery may improve learning and provides an opportunity for pre-operative surgical rehearsal. We describe a novel haptic temporal bone simulator developed for multicore processing and improved visual realism. A position locking algorithm for enhanced drill-bone interaction and haptic fidelity is further employed. The simulation construct is evaluated against cadaveric education. The Cadaveric Temporal Bone Lab remains the gold standard; access to sufficient exposure is site specific owing to local factors and expense [1]. Movement of the manipulandum guides the virtual drill tip. As the virtual bone is drilled, deep structures are revealed, permitting simulated complex surgical procedures. While this does provide a sense of drill-bone interaction, the experience is not identical to that of operative drilling
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