Examining the utility of a photorealistic virtual ear in otologic education.

Background: Otolaryngology-head and neck surgical (OHNS) trainees' operating exposure is supplemented by a combination of didactic teaching, textbook reading, and cadaveric dissections. Conventional teaching, however, may not adequately equip trainees with an understanding of complex visuospatial relationships of the middle ear. Both face and content validation were assessed of a novel three-dimensional (3D) photorealistic virtual ear simulation tool underwent face and content validation as an educational tool for OHNS trainees.

Correction to: Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study.

Following publication of the original article [1], the authors identified incorrect ordering and incorrect files being used for Figs. 1, 2 and 3.

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study.

Background: Trainees in Otolaryngology-Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology.

Simulation-Based Structured Education Supports Focused Neonatal Cranial Ultrasound Training.

Objectives: Brain injury in preterm neonates may cause clinical deterioration and requires timeous bedside diagnosis. Teaching cranial ultrasound (US) skills using fragile preterm neonates is challenging. The purpose of this study was to test the effectiveness and feasibility of using task-trainer computer-based simulators and US-suitable cranial phantoms in combination with teaching sessions in teaching novices to perform focused cranial US evaluations for identifying substantial intraventricular hemorrhage.

Validation of a rhinologic virtual surgical simulator for performing a Draf 3 endoscopic frontal sinusotomy.

Background: We recently introduced a patient-specific rhinologic virtual surgical environment (VSE) that has shown potential for surgical rehearsal of various skull base lesions. Our aim in this study was to validate the usefulness of the rhinology VSE in performing the Draf 3 procedure.

Methods: An outside-in Draf 3 procedure was performed on 4 cadaver heads.

Early experience with a patient-specific virtual surgical simulation for rehearsal of endoscopic skull-base surgery.

Background: With the help of contemporary computer technology it is possible to create a virtual surgical environment (VSE) for training. This article describes a patient-specific virtual rhinologic surgical simulation platform that supports rehearsal of endoscopic skull-base surgery. We also share our early experience with select cases.

Design-Based Comparison of Spine Surgery Simulators: Optimizing Educational Features of Surgical Simulators.

Background: Simulation-based education has made its entry into surgical residency training, particularly as an adjunct to hands-on clinical experience. However, one of the ongoing challenges to wide adoption is the capacity of simulators to incorporate educational features required for effective learning. The aim of this study was to identify strengths and limitations of spine simulators to characterize design elements that are essential in enhancing resident education.

Systematic Review of Patient-Specific Surgical Simulation: Toward Advancing Medical Education.

Objective: Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training.

Anatomy-Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence.

Objective To evaluate the effect of anatomy-specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance. Study Design Prospective pre- and poststudy of a novel virtual surgical rehearsal platform. Setting Academic otolaryngology-head and neck surgery residency training programs.

Expert subjective comparison of haptic models for bone-drill interaction.

Purpose: A haptic algorithm to simulate the interaction between a surgical drill and bone using a constraint-based algorithm has been previously demonstrated. However, there has been no blinded study to determine whether this algorithm is preferred by professionals who commonly use this type of system METHODS: Fourteen otologic surgeons were presented with a spring-damper model and a constraint-based model of drill-bone interaction rendered on a low-cost haptic device with only linear feedback. The participants were blinded as to what algorithm they were using.

High-fidelity haptic and visual rendering for patient-specific simulation of temporal bone surgery.

Medical imaging techniques provide a wealth of information for surgical preparation, but it is still often the case that surgeons are examining three-dimensional pre-operative image data as a series of two-dimensional images. With recent advances in visual computing and interactive technologies, there is much opportunity to provide surgeons an ability to actively manipulate and interpret digital image data in a surgically meaningful way. This article describes the design and initial evaluation of a virtual surgical environment that supports patient-specific simulation of temporal bone surgery using pre-operative medical image data.

Supplementary Educational Models in Canadian Neurosurgery Residency Programs.

Background: The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion. We aimed to better understand the role of supplementary educational methods in Canadian neurosurgery residency training.

Evaluation of haptic interfaces for simulation of drill vibration in virtual temporal bone surgery.

Surgical training is evolving from an observership model towards a new paradigm that includes virtual-reality (VR) simulation. In otolaryngology, temporal bone dissection has become intimately linked with VR simulation as the complexity of anatomy demands a high level of surgeon aptitude and confidence. While an adequate 3D visualization of the surgical site is available in current simulators, the force feedback rendered during haptic interaction does not convey vibrations.

Evaluation of Software Tools for Segmentation of Temporal Bone Anatomy.

Surgeons are increasingly relying on 3D medical image data for planning interventions. Virtual 3D models of intricate anatomy, such as that found within the temporal bone, have proven useful for surgical education, planning, and rehearsal, but such applications require segmentation of surgically relevant structures in the image data. Four publicly available software packages, ITK-SNAP, MITK, 3D Slicer, and Seg3D, were evaluated for their efficacy in segmenting temporal bone anatomy from CT and MR images to support patient-specific surgery simulation.

The effect of haptic degrees of freedom on task performance in virtual surgical environments.

Force and touch feedback, or haptics, can play a significant role in the realism of virtual reality surgical simulation. While it is accepted that simulators providing haptic feedback often outperform those that do not, little is known about the degree of haptic fidelity required to achieve simulation objectives. This article evaluates the effect that employing haptic rendering with different degrees of freedom (DOF) has on task performance in a virtual environment.

Virtual reality simulation in neurosurgery: technologies and evolution.

Neurosurgeons are faced with the challenge of learning, planning, and performing increasingly complex surgical procedures in which there is little room for error. With improvements in computational power and advances in visual and haptic display technologies, virtual surgical environments can now offer potential benefits for surgical training, planning, and rehearsal in a safe, simulated setting. This article introduces the various classes of surgical simulators and their respective purposes through a brief survey of representative simulation systems in the context of neurosurgery.

A virtual surgical environment for rehearsal of tympanomastoidectomy.

This article presents a virtual surgical environment whose purpose is to assist the surgeon in preparation for individual cases. The system constructs interactive anatomical models from patient-specific, multi-modal preoperative image data, and incorporates new methods for visually and haptically rendering the volumetric data. Evaluation of the system's ability to replicate temporal bone dissections for tympanomastoidectomy, using intraoperative video of the same patients as guides, showed strong correlations between virtual and intraoperative anatomy.

Reconstruction and exploration of virtual middle-ear models derived from micro-CT datasets.

Background: Middle-ear anatomy is integrally linked to both its normal function and its response to disease processes. Micro-CT imaging provides an opportunity to capture high-resolution anatomical data in a relatively quick and non-destructive manner. However, to optimally extract functionally relevant details, an intuitive means of reconstructing and interacting with these data is needed.

Integration of patient-specific paranasal sinus computed tomographic data into a virtual surgical environment.

Background: The advent of both high-resolution computed tomographic (CT) imaging and minimally invasive endoscopic techniques has led to revolutionary advances in sinus surgery. However, the rhinologist is left to make the conceptual jump between static cross-sectional images and the anatomy encountered intraoperatively. A three-dimensional (3D) visuo-haptic representation of the patient's anatomy may allow for enhanced preoperative planning and rehearsal, with the goal of improving outcomes, decreasing complications, and enhancing technical skills.