Virtual reality: a new paranasal sinus surgery simulator.
OBJECTIVE
Virtual surgical training systems are of growing value. Current prototypes for endonasal sinus surgery simulation are very expensive or lack running stability. No reliable system is available to a notable number of users yet. The purpose of this work was to develop a dependable simulator running on standard PC hardware including a detailed anatomic model, realistic tools and handling, stereoscopic view, and force feedback.


METHODS
Descriptive.


METHODS
A three-dimensional voxel model was created based on a high-resolution computed tomography study of a human skull, from which the bony structures were segmented. The mucosa and organs at risk were added manually. The model may be manipulated with virtual surgical tools controlled with a low-cost haptic device, which is also used to adjust microscopic or endoscopic views. Visualization, haptic rendering, and tissue removal are represented with subvoxel resolution.


RESULTS
The handling of the model is convincing. The haptic device provides a realistic feeling regarding the interaction between tool tip and anatomy. Three-dimensional orientation and the look and feel of virtual surgical interventions get close to reality.


CONCLUSIONS
The newly developed system is a stable, fully operational simulator for sinus surgery based on standard PC hardware. Besides the limitations of a low-cost haptic device, the presented system is highly realistic regarding anatomy, visualization, manipulation, and the appearance of the tools. It is mainly intended for gaining surgical anatomy knowledge and for training navigation in a complex anatomical environment. Learning effects, including motor skills, have yet to be quantified.
Tolsdorff
Boris
B
Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany. tolsdorff_b@klinik.uni-wuerzburg.de
Pommert
Andreas
A
Höhne
Karl Heinz
KH
Petersik
Andreas
A
Pflesser
Bernhard
B
Tiede
Ulf
U
Leuwer
Rudolf
R
D003198:Computer Simulation; D004724:Endoscopy / Q000193:education*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education*; D010256:Paranasal Sinuses / Q000601:surgery*; D014584:User-Computer Interface