SLAM-based Trackerless Navigation System for Lateral Skull base Surgery: A Pilot Cadaver Study

Abstract

Lateral skull base surgery requires drilling near del- icate structures with high accuracy. Misidentification of anatomy within the opaque temporal bone can lead to inadvertent surgical complications with high morbidity including facial paralysis, hearing loss, and dysequi- librium. Given that benign pathology is typically the indication for surgery, it is of elevated importance for the lateral skull base surgeon to deftly tread the line between underexposure, which risks persistent disease, and overexposure, which risks iatrogenic injury. The safety and efficacy of lateral skull base surgery may be improved with a viable surgical navigation system. Despite the availability of surgical navigation systems for nearly three decades, they are infrequently used for lateral skull base surgeries. The navigation systems depend on external tracking equipment and can suffer from cumbersome registration and calibration steps, and suffer from metallic interference or line-of-sight issues. Moreover, for lateral skull base surgery, the patient head position may be adjusted intraoperatively and result in a significant registration error.