A System for Characterizing Intraoperative Force Distribution during Operative Laryngoscopy.

This study aimed to create and validate an integrated data acquisition system for gauging the force distribution between a laryngoscope and soft-tissue during trans- oral surgery.Sixteen piezoresistive force sensors were interfaced to a laryngoscope and custom maxillary tooth guard. A protocol for calibrating the laryngoscope and maxilla sensors was developed using a motor-controlled linear stage and force measurements were validated against a digital scale. The system was initially tested during suspension laryngoscopy on three cadaver heads mounted on a cadaver head-holder. Intraoperative data was also collected from three patients undergoing head and neck tumor resection.Mean calibration error of the scope sensors was less than 150 g (n=3) and mean maxilla sensor error was less than 200 g (n=3). Peak scope mag-forces of 8.09±6.61 kg and peak maxilla forces of 7.62±4.57 kg were experienced during the cadaver trials. The peak scope sensor mag-force recorded during the intraoperative cases was 24.7±4.53 kg, and the peak maxilla force was 22.0±4.60 kg.The data acquisition system was successfully able to record intraoperative force distribution data. The usefulness of this technology in informing surgeons during trans-oral surgery should be further evaluated in patients with varying anatomic and procedural characteristics.Creation of a low-cost, integrated force-sensing system allows for the characterization of retraction forces at anatomic sites including the pharynx and larynx, brain, and abdomen. Real-time force detection provides surgeons with valuable intraoperative feedback and can be used to improve deformation models at various anatomic sites.