A virtual reality ear ossicle surgery simulator using three-dimensional computer tomography

This paper describes a virtual reality simulator for middle ear ossicle surgery. An automatic segmentation method has been developed to segment tiny ear ossicles at transverse computer tomography (CT) slices. Surgeons can therefore easily observe the three-dimensional (3D) geometry of the segmented ossicles by the volume reconstruction and the spatial relation with the temporal bone to diagnose middle ear disease. Surgeons can use a virtual reality round cutting bur to cut the temporal bone for opening the 3D tympanic cavity, and a virtual reality round polishing bur to cut for separating ear ossicles from other bones or to polish the adhered tissue sclerosis on the ear ossicles. These burring simulations can achieve real-time visual and haptic responses based on our reported volume manipulation methods. A technique is developed to judge if a separation among the ossicles or from the temporal bone occurs during the burring simulations so that repositioning simulations can be followed to align the ear ossicles. A simulation example of a real ear ossicle surgery demonstrates these simulation functions work well even for tiny ossicles and thus shows the effectiveness of the surgical simulator to rehearse the surgical procedures, confirm surgical plans and train interns and students.