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RESEARCH PRODUCT

Augmented Reality in minimally invasive otologic surgery and transmodiolar cochlear implantation

subject

description

Optimal exposure is necessary for minimally invasive otologic surgery. Augmented reality allows to enrich the real environment by adding data without replacing it by a virtual environment and to view this information on a single screen by combining the vision of the operating field and the imaging. This technique is very little described in otology in the literature. This project aims to develop augmented reality solutions for otological surgeries and transmodiolar implantation. To prepare this augmented reality project, we studied the visualization of the middle ear by a virtual endoscope based on preoperative high resolution CT-scans. Then, we worked on the application of augmented reality to transtympanic otologic surgery in order to design a minimally invasive system based solely on vision algorithms thanks to the superposition of images from pre-operative CT-scans with those recorded in real time corresponding to the surgeon's intraoperative vision without the need for traditional tracking systems (magnetic and/or optical). This allowed us to visualize the anatomical structures of the tympanic cavity and to mobilize a micro-instrument in the tympanic cavity without lifting the tympano-meatal flap. At the same time, we developed the augmented reality system applied to transmodiolar implantation that allowed visualization of the entry point and axis of the modiolus on the surgical video which are not visible directly by vision of the otologic surgeon. During this work, we were able to show that augmented reality has an interest in the development of minimally invasive otologic surgery, both in the approach and in the surgical technique, and opens perspectives for future work.