Customized, rapid-production microstereotactic table for surgical targeting: description of concept and in vitro validation.
OBJECTIVE
To introduce a novel microstereotactic frame, called the Microtable, consisting of a tabletop that mounts on bone-implanted spherical markers. The microtable is customized for individual patient anatomy to guide a surgical instrument to a specified target.


METHODS
Fiducial markers are bone-implanted, and CT scanning is performed. A microtable is custom-designed for the location of the markers and the desired surgical trajectory and is constructed using a computer-numerical-control machine. Validation studies were performed on phantoms with geometry similar to that for cochlear implant surgery. Two designs were tested with two different types of fiducial markers.


RESULTS
Mean targeting error of the microtables for the two designs were 0.37 +/- 0.18 and 0.60 +/- 0.21 mm (n = 5). Construction of each microtable required approximately 6 min.


CONCLUSIONS
The new frame achieves both high accuracy and rapid fabrication. We are currently using the microtable for clinical testing of the concept of percutaneous cochlear implant surgery.
Labadie
Robert F
RF
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. robert.labadie@vanderbilt.edu
Mitchell
Jason
J
Balachandran
Ramya
R
Fitzpatrick
J Michael
JM
D019929:Cochlear Implantation / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008866:Microsurgery / Q000295:instrumentation*; D009873:Operating Rooms; D019047:Phantoms, Imaging; D012372:ROC Curve; D016634:Radiosurgery / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000379:methods*