Evaluation of intraoperative cone beam computed tomography and optical drill tracking in temporal bone surgery
Bibliographic record
Abstract
OBJECTIVES/HYPOTHESIS: A prototype system for intraoperative cone beam computed tomography (CBCT) imaging has been developed and augmented with real time optical tracking of a surgical drill. We hypothesize that this system provides sufficient accuracy for guidance of temporal bone surgery. STUDY DESIGN: Basic research. METHODS: Measurements of drill localization accuracy using CBCT imaging were obtained with a custom three-dimensional calibration object. Integrated CBCT imaging and drill tracking were prospectively evaluated on 12 cadaver temporal bones. Six inexperienced and six experienced surgeons conducted four surgical tasks: cortical mastoidectomy, posterior tympanotomy, cochleostomy, and a translabyrinthine approach to the internal auditory canal. Questionnaires provided expert feedback on tracking accuracy and system usability. RESULTS: Target registration error measurements of drill tracking accuracy and precision yielded a mean of 0.76 mm, a maximum of 1.30 mm, and a standard deviation of 0.21 mm. Anatomical landmark identification tasks (e.g., facial nerve, incus, semicircular canals, cochlea) provided additional validation of system accuracy. The usability and utility of the guidance system were positively rated by both groups of surgeons, with further modifications underway to improve tracking line of sight and registration workflow. Experienced but in particular inexperienced surgeons indicated significant benefits in cases involving extensive disease, abnormal anatomy, and loss of anatomical landmarks. CONCLUSIONS: The integration of intraoperative CBCT imaging with optical tracking provides sufficient accuracy to localize anatomical structures within the temporal bone using an otological drill. Future studies will explore the role of this technology in complex oncological resections, in surgery for congenital anomalies, and as a tool for teaching.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".