Developing a virtual reality environment in petrous bone surgery: A state-of-the-art review

The technical limitations restricting the production of VR surgical simulators have largely been surmounted. Improved imaging devices can produce data of adequately high spatial resolution and signal-to-noise ratio to provide a basis for modeling of the virtual environment. Coregistration of data sets and the automated segmentation of anatomic structures are made possible by improvements in algorithmic approaches and computing power. Physical modeling, at least of rigid structures, is becoming increasingly sophisticated, and the improvements in visual and haptic feedback systems allow true subject interaction in a stereoscopically rendered 3-D environment. Most importantly, the use of dedicated graphics hardware and multiprocessor computers has reduced the time taken for volume rendering techniques to the point where it is feasible to perform these tasks at a rate sufficient to resemble continuous motion to a human. The combination of these technologies will be challenging but offers every promise of a routine clinically useable surgical simulator for use in hospital settings.