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CT-based manual segmentation and evaluation of paranasal sinuses

  • Rhinology
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Abstract

Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots’ workspace definition. A total of 50 preselected CT datasets were each segmented in 150–200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8–10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm³, left side 17.9 cm³, right frontal sinus 4.2 cm³, left side 4.0 cm³, total frontal sinuses 7.9 cm³, sphenoid sinus right side 5.3 cm³, left side 5.5 cm³, total sphenoid sinus volume 11.2 cm³. Our manually segmented 3D-models present the patient’s individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot’s maximum distance to the segmented border can be adjusted according to the differently colored areas.

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Acknowledgments

This work is part of the project “Robot-assisted intuitive endoscope navigation in endonasal surgeries with the help of preoperative computed tomography (CT) or magnetic resonance imaging (MRI) analysis” and we are grateful to the Deutsche Forschungsgemeinschaft (DFG) for funding this project. Bonfor, a research trust of the University of Bonn, is funding this project as well. The authors wish to express their thanks to Prof. Dr. K. Schild and Priv.-Doz. Dr. med. Wilhelm of the Radiology Clinic of the University of Bonn for providing CT image data.

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Authors and Affiliations

  1. Clinic und Policlinic of Otolaryngology/Ear, Nose and Throat Surgery, University of Bonn, Bonn, Germany

    S. Pirner, K. Tingelhoff, I. Wagner, F. Bootz & Klaus W. G. Eichhorn

  2. Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

    Klaus W. G. Eichhorn

  3. Institute of Robotics and Process Control, Technical University of Braunschweig, Braunschweig, Germany

    R. Westphal, M. Rilk & F. M. Wahl

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  1. S. Pirner
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  2. K. Tingelhoff
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  3. I. Wagner
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  4. R. Westphal
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  5. M. Rilk
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  6. F. M. Wahl
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  7. F. Bootz
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  8. Klaus W. G. Eichhorn
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Correspondence to Klaus W. G. Eichhorn.

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Pirner, S., Tingelhoff, K., Wagner, I. et al. CT-based manual segmentation and evaluation of paranasal sinuses. Eur Arch Otorhinolaryngol 266, 507–518 (2009). https://doi.org/10.1007/s00405-008-0777-7

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  • DOI: https://doi.org/10.1007/s00405-008-0777-7

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