Augmented reality for inner ear procedures: visualization of the cochlear central axis in microscopic videos
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ORIGINAL ARTICLE
Augmented reality for inner ear procedures: visualization of the cochlear central axis in microscopic videos Raabid Hussain1
· Alain Lalande1,2 · Kibrom Berihu Girum1 · Caroline Guigou1,3 · Alexis Bozorg Grayeli1,3
Received: 14 November 2019 / Accepted: 20 July 2020 © CARS 2020
Abstract Purpose Visualization of the cochlea is impossible due to the delicate and intricate ear anatomy. Augmented reality may be used to perform auditory nerve implantation by transmodiolar approach in patients with profound hearing loss. Methods We present an augmented reality system for the visualization of the cochlear axis in surgical videos. The system starts with an automatic anatomical landmark detection in preoperative computed tomography images based on deep reinforcement learning. These landmarks are used to register the preoperative geometry with the real-time microscopic video captured inside the auditory canal. Three-dimensional pose of the cochlear axis is determined using the registration projection matrices. In addition, the patient microscope movements are tracked using an image feature-based tracking process. Results The landmark detection stage yielded an average localization error of 2.18±1.44 mm (n = 8). The target registration error was 0.31 ± 0.10 mm for the cochlear apex and 15.10 ± 1.28◦ for the cochlear axis. Conclusion We developed an augmented reality system to visualize the cochlear axis in intraoperative videos. The system yielded millimetric accuracy and remained stable throughout the experimental study despite camera movements throughout the procedure in experimental conditions. Keywords Augmented reality · Cochlea · Otology · Landmark detection · Reinforcement learning
Introduction The human ear is composed of some of the smallest bones in the body. Critical structures such as blood vessels, facial, vestibular and auditory nerves are present in close vicinity of target structures such as ossicles and labyrinthine windows during an otologic surgery, requiring an accurate and robust estimation of the anatomy during intraoperative procedures. The human ear can be separated into three parts: The outer part consists of the pinna and the external auditory canal and participates in collecting and amplifying the sound waves. The middle ear is composed of the tympanic membrane, the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11548-020-02240-w) contains supplementary material, which is available to authorized users.
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Raabid Hussain [email protected]
1
ImViA Laboratory, University of Burgundy, Batiment I3M, 64b Rue Sully, 21000 Dijon, France
2
Medical Imaging Department, CHU Dijon, Dijon, France
3
ENT Department, CHU Dijon, Dijon, France
ossicles (malleus, incus and stapes) and the mastoid cavity. It further amplifies the acoustic energy and delivers it to the inner ear. This latter structure includes the cochlea which processes the acoustic signal and transforms it into electrical impulses conveyed to the auditory centers
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