Imaging based metrics for performance assessment in laser phonomicrosurgery

State-of-the-art laser phonomicrosurgery (LP) used for the treatment of laryngeal abnormalities involves complex otolaryngological surgical techniques. It relies heavily on surgeon dexterity, requiring significant psychomotor skills. Equipment scale and size, laser operative distance, and the anatomically small nature of the vocal folds all combine to compound the surgical challenges. An objective measurement is therefore necessary to understand the impact of equipment design, its usability, surgeon skill, and learning, on performing LP effectively. This paper introduces imaging based feature extraction as a method to establish metrics to assess surgical performance in LP. Experimental analysis demonstrates the utility of these metrics in measuring surgical task execution vis-à-vis the task objectives. The metrics also provide for a combined rating scale giving a robust quantitative classification of the levels of surgical performance.