title: Surgical assistance for instruments' power control based on navigation and neuromonitoring.
abstract: In order to prevent nerve injuries during ear-nose-throat (ENT) and skull base surgery, the method Navigated Control Functional is presented. Thereby, the power of active instruments is controlled based on position information, provided by a surgical navigation system, and nerve activity information, provided by a neurophysiologic monitoring system. Electrical stimulation is usually required for the extraction of distance information from neurophysiologic signals (e.g., Electromyography (EMG)). However, this article presents an experiment to investigate a possible relationship between EMG signals and the nerve-instrument distance without additional electrical stimulation. The EMG signals and position information were recorded intra-operatively during ear surgery. An off-line statistical analysis with Spearman's rank correlation coefficient was accomplished. The results show that there is occasionally some correlation at a statistically significant level of 5%. They highly depend on time range, the selected threshold value and time window. Moreover, all the observed correlations are positive against an expected negative correlation.
authors.affiliation: Institute for Micro Technology and Medical Device Technology, Technical University of Munich, D-85748 Garching, Germany. jiaxi.shi@tum.de
authors.forename: Jiaxi
authors.initials: J
authors.lastname: Shi
authors.forename: Gero
authors.initials: G
authors.lastname: Strauss
authors.forename: Sebastian
authors.initials: S
authors.lastname: Heininger
authors.forename: Tim C
authors.initials: TC
authors.lastname: Lueth
mesh_terms: D003943:Diagnostic Techniques, Neurological / Q000295:instrumentation*; D004558:Electric Stimulation / Q000295:instrumentation*; D004576:Electromyography / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005154:Facial Nerve / Q000503:physiopathology*; D006801:Humans; D013506:Otologic Surgical Procedures / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*