Implementierung eines miniaturisierten Navigationssystems in der Kopf- Halschirurgie zur Fremdkörperdetektion und Entfernung

Abstract

The detection and surgical removal of foreign bodies from the head and neck area of the human body is a demanding task even for experienced head and neck surgeons. Especially soldiers suffer from foreign body injuries in the head and neck area due to the more frequent use of IED (ImprovisedExplosiveDevices) by their enemies. A simple and efficient tool to help surgeons in removing these foreign bodies would be big advantage for the treatment in hospitals where the combat misson is at. In an experimental setting using 10 human head and neck preparations from body donors it could be shown that the use of computer assisted surgery for removing foreign bodies is very effective and helpful. The head and neck preparations had been loaded with 5 different foreign bodies typical for IEDs (wood, stone, metal, plastic and glass) at both hemi sides of the head. One hemi was treated conventionally using CT scan screen shots and palpation to detect and remove the foreign bodies. The other hemi was treated using a miniaturised and ultra portabel computer assisted surgery unit. The comparison of both procedures revealed that with the help of computer assisted surgery radiopaque foreign bodies could be detected faster (p<0,0001) and more efficient (p=0,0255). The removal was faster (p=0,0239) and less traumatic (p=0,0007). Furthermore, the soft tissue shift for the foreign bodies was recorded and in this experimental setting 80 % of the foreign bodies had a non-relevant soft tissue shift. In summary, this study identifies computer assisted surgery as a far superior procedure for the identification and removal of foreign objects compared to the CT scan method.