A minimally invasive registration method using Surface Template-Assisted Marker Positioning (STAMP) for image-guided otologic surgery

Objective: A new, minimally invasive registration method was developed for image-guided otologic surgery. We utilized laser-sintered template of the patient's bone surface to transfer the virtual markers to the patient's bone intraoperatively and eliminated the necessity for preoperative marker positioning or additional CT scan. Study Design: Simulation surgeries and clinical application. Subjects and Methods: We measured registration errors in 10 trials using replicas and six ear surgeries (two cochlear implant insertions, four translabyrinthine acoustic tumor removals). Results: The target registration errors varied among the surgical targets. Errors were less than 1 mm near the cochlear implant insertion target both in phantom study and in actual surgeries. Conclusion: Our newly developed method reduced the preoperative procedures for patients but did not reduce the accuracy in cochlear implant surgery. Our method would be a useful image-guided surgery method in the field of otology, where both accuracy and noninvasiveness are required.