Minimally Invasive Multiport Surgery of the Lateral Skull Base

Abstract EN

Objective.

Minimally invasive procedures minimize iatrogenic tissue damage and lead to a lower complication rate and high patient satisfaction.

To date only experimental minimally invasive single-port approaches to the lateral skull base have been attempted.

The aim of this study was to verify the feasibility of a minimally invasive multiport approach for advanced manipulation capability and visual control and develop a software tool for preoperative planning.

Methods.

Anatomical 3D models were extracted from twenty regular temporal bone CT scans.

Collision-free trajectories, targeting the internal auditory canal, round window, and petrous apex, were simulated with a specially designed planning software tool.

A set of three collision-free trajectories was selected by skull base surgeons concerning the maximization of the distance to critical structures and the angles between the trajectories.

Results.

A set of three collision-free trajectories could be successfully simulated to the three targets in each temporal bone model without violating critical anatomical structures.

Conclusion.

A minimally invasive multiport approach to the lateral skull base is feasible.

The developed software is the first step for preoperative planning.

Further studies will focus on cadaveric and clinical translation.