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BioMed Research International
Volume 2014 (2014), Article ID 379295, 7 pages
Research Article

Minimally Invasive Multiport Surgery of the Lateral Skull Base

1Department of Otorhinolaryngology, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
2Interactive Graphics Systems Group, Technical University Darmstadt, 64283 Darmstadt, Germany

Received 14 February 2014; Accepted 2 June 2014; Published 2 July 2014

Academic Editor: Marco Caversaccio

Copyright © 2014 Igor Stenin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Minimally invasive procedures minimize iatrogenic tissue damage and lead to a lower complication rate and high patient satisfaction. To date only experimental minimally invasive single-port approaches to the lateral skull base have been attempted. The aim of this study was to verify the feasibility of a minimally invasive multiport approach for advanced manipulation capability and visual control and develop a software tool for preoperative planning. Methods. Anatomical 3D models were extracted from twenty regular temporal bone CT scans. Collision-free trajectories, targeting the internal auditory canal, round window, and petrous apex, were simulated with a specially designed planning software tool. A set of three collision-free trajectories was selected by skull base surgeons concerning the maximization of the distance to critical structures and the angles between the trajectories. Results. A set of three collision-free trajectories could be successfully simulated to the three targets in each temporal bone model without violating critical anatomical structures. Conclusion. A minimally invasive multiport approach to the lateral skull base is feasible. The developed software is the first step for preoperative planning. Further studies will focus on cadaveric and clinical translation.