We are constructing a database where CardinalSim user can share simulated cases.  In this way, users will have access to a growing repository of anonymized data from which to learn anatomic variations and surgical approaches to a spectrum of pathology.

Such a simulation database will allow users to share challenging cases and clinical scenarios with a network of users to receive feedback on planned procedures for their patients.

In this way, users will be able to search for specific pathology or anatomic variations that pertain to the clinical challenges they face to gain insight into how others have manages similar scenarios.

We are designing means through which users can refine simulated surgical approaches in a collaborative, iterative process.

This schematic example illustrates a case in which a resident is attempting to optimize an approach to a temporal bone tumor (green) while avoiding the carotid (red) and jugular bulb (blue).  He removes bone (black) to go from A to B, but is unable to reach the tumor.

He would be able to then ask for assistance from a more senior resident, who takes his dissection down a different branch, showing him how to try an alternative approach (C).

Next, the dissection is reviewed by a more senior attending, who recommends removing additional bone (light green) to facilitate the approach as shown in (D).

Provided with this guidance, the initial resident can now refine his initial approach, reaching an optomized solution (E), and saving it to the database as a model case for others to reference.

We are currently integrating realistic sound created by the removal of bone with an surgical drill.  Experienced surgeons use subtle auditory cues to learn valuable information regarding the state of the drill and bur used, but also the characteristics and geometry of the underlying bone.

By supplying the user with these cues, we hypothesize that CardinalSim will be more realistic – allowing surgeons to achieve their desired goals faster and more accurately.

Early work by our team in the simulation of surgical bone removal. Spectral peaks of both cutting and diamond burs are shown here.

Data accepted for presentation at AAO/HNS Annual Meeting, 2016