Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Toward automatic atlas-based surgical planning for septoplasty. Int J Comput Assist Radiol Surg 2022 Feb;17(2):403-411

Date

11/28/2021

Pubmed ID

34837564

DOI

10.1007/s11548-021-02524-9

Scopus ID

2-s2.0-85120064392 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

PURPOSE: Surgery for nasal airway obstruction (NAO) has a high failure rate, with up to 50% of patients reporting persistent symptoms postoperatively. Virtual surgery planning has the potential to improve surgical outcomes, but current manual methods are too labor-intensive to be adopted on a large scale. This manuscript introduces an automatic atlas-based approach for performing virtual septoplasties.

METHODS: A cohort of 47 healthy subjects and 26 NAO patients was investigated. An atlas of healthy nasal geometry was constructed. The automatic virtual septoplasty method consists of a multi-stage registration approach to fit the atlas to a target NAO patient, automatically segment the patient's septum and airway, and deform the patient image to have a non-deviated septum.

RESULTS: Our automatic virtual septoplasty method straightened the septum successfully in 18 out of 26 NAO patients (69% of cases). In these cases, the ratio of the higher to the lower airspace cross-sectional areas in the left and right nasal cavities improved from 1.47 ± 0.45 to 1.16 ± 0.33 in the region surrounding the septal deviation, showing that the nasal airway became more symmetric after virtual septoplasty.

CONCLUSION: This automated virtual septoplasty technique has the potential to greatly reduce the effort required to perform computational fluid dynamics (CFD) analysis of nasal airflow for NAO surgical planning. Future studies are needed to investigate if virtual surgery planning using this method is predictive of subjective symptoms in NAO patients after septoplasty.

Author List

Vicory J, Garcia GJM, Rhee JS, Enquobahrie A

Authors

Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of Wisconsin
John S. Rhee MD Chair, Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Humans
Hydrodynamics
Nasal Cavity
Nasal Obstruction
Nasal Septum
Rhinoplasty
Treatment Outcome