A preregistered STAMP method for image-guided temporal bone surgery

Objectives: Image-guided otological surgeries require minimal invasiveness and high accuracy, and these two factors usually compete with each other. Our recently developed registration method, called the STAMP method, showed minimal invasiveness with accuracy comparable to that of the current more invasive registration methods used in image-guided temporal bone surgery. However, surgeons perceived the STAMP method as complex and time-consuming. Methods: We modified our STAMP method to further simplify the surgeon's tasks in the operating room. We attached an optical tracking target on the STAMP plate and registered the plate in an IGS system before surgery, outside the operating room. The registration was completed in the operating room by finishing the final simple task, which was to hold the preregistered STAMP plate still on the patient's temporal bone. We tested this modified preregistered STAMP method in simulation surgery and actual surgeries. The registration times and errors of the STAMP method and preregistered STAMP method were compared. Results: The proposed new preregistered STAMP method significantly reduced the registration time in the operating room without compromising the registration accuracy. Conclusions: The preregistered STAMP method significantly improved the original STAMP method in terms of time and convenience. It is now considered to be one of the easiest and quickest registrations for image-guided temporal bone surgery. Because most of the critical processes of registration can be completed in the laboratory, the registration task in the operating room is therefore greatly simplified, thus allowing surgeons to concentrate more on the surgery itself.