title: Positioning Accuracy in Otosurgery Measured with Optical Tracking.
abstract: To assess positioning accuracy in otosurgery and to test the impact of the two-handed instrument holding technique and the instrument support technique on surgical precision. To test an otologic training model with optical tracking.
  
  
  
  In total, 14 ENT surgeons in the same department with different levels of surgical experience performed static and dynamic tasks with otologic microinstruments under simulated otosurgical conditions.
  
  
  
  Tip motion of the microinstrument was registered in three dimensions by optical tracking during 10 different tasks simulating surgical steps such as prosthesis crimping and dissection of the middle ear using formalin-fixed temporal bone. Instrument marker trajectories were compared within groups of experienced and less experienced surgeons performing uncompensated or compensated exercises.
  
  
  
  Experienced surgeons have significantly better positioning accuracy than novice ear surgeons in terms of mean displacement values of marker trajectories. The instrument support and the two-handed instrument holding techniques significantly reduce surgeons' tremor. The laboratory set-up presented in this study provides precise feedback for otosurgeons about their surgical skills and proved to be a useful device for otosurgical training.
  
  
  
  Simple tremor compensation techniques may offer trainees the potential to improve their positioning accuracy to the level of more experienced surgeons. Training in an experimental otologic environment with optical tracking may aid acquisition of technical skills in middle ear surgery and potentially shorten the learning curve. Thus, simulated exercises of surgical steps should be integrated into the training of otosurgeons.
authors.affiliation: Department of Oto-Rhino-Laryngology, Head & Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
authors.forename: Attila
authors.initials: A
authors.lastname: Óvári
authors.affiliation: Department of Neurology, University Medical Center, Rostock, Germany.
authors.forename: Dóra
authors.initials: D
authors.lastname: Neményi
authors.affiliation: Department of Oto-Rhino-Laryngology, KMG Klinikum Güstrow GmbH, Güstrow, Germany.
authors.forename: Tino
authors.initials: T
authors.lastname: Just
authors.affiliation: Department of Oto-Rhino-Laryngology, Head & Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schuldt
authors.affiliation: Department of Oto-Rhino-Laryngology, Head & Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Buhr
authors.affiliation: Department of Oto-Rhino-Laryngology, Head & Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Mlynski
authors.affiliation: Department of Neurosurgery, Military Hospital, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Csókay
authors.affiliation: Department of Oto-Rhino-Laryngology, Head & Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
authors.forename: Hans-Wilhelm
authors.initials: HW
authors.lastname: Pau
authors.affiliation: Department of Neurosurgery, St. John's Hospital, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Valálik
mesh_terms: D004432:Ear, Middle / Q000601:surgery*; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures / Q000193:education / Q000379:methods; D013701:Temporal Bone / Q000601:surgery*