Human Middle Ear Anatomy Based on Micro-Computed Tomography and Reconstruction: An Immersive Virtual Reality Development
, Ian Curthoys 2, Hamish MacDougall 3, Jonathan Robert Clark 1,4,5 and Payal Mukherjee 1Round 1
Reviewer 1 Report
The authors studied the optimisation method for visualising the middle ear mesh model reconstructed from micro CT in an immersive VR environment. The study may contribute to the future development in the training of ENT surgeon.
Comments:
1. "outer wall of the middle ear" -- I'm not sure what the authors mean by "outer wall", I think should be "the wall of the middle ear".
2. For fig.1, to change picture 1 to reflect the study done.
3. in 2.1, to include "middle ear" in the statement of extraction.
4. references should be done in a systematic way.
Author Response
The authors studied the optimisation method for visualising the middle ear mesh model reconstructed from micro CT in an immersive VR environment. The study may contribute to the future development in the training of ENT surgeon.
Thank you for the invaluable input provided by the reviewer.
We have implemented the necessary changes in response to the reviewer's comments.
Comments:
- "outer wall of the middle ear" -- I'm not sure what the authors mean by "outer wall", I think should be "the wall of the middle ear".
“outer wall of the middle ear” changed to “the anatomy of the middle ear”
- For fig.1, to change picture 1 to reflect the study done.
Change implemented.
- in 2.1, to include "middle ear" in the statement of extraction.
Change implemented.
A sample of six fresh frozen temporal bones was dissected to extract the otic capsule with an intact tympanic membrane, which contains the middle ear.
- references should be done in a systematic way.
Change implemented.
Reference re-formatted for a systematic presentation
Reviewer 2 Report
It is strongly recommended that the summary be rewritten in order to highlight the most important contributions and the results that were obtained. It is important to note that in recent years, the utilisation of 3D animation simulators in medical settings at a higher level has become quite commonplace.
The current state of the art is briefly discussed in both the introduction and the first topics. It is recommended that this state of the art be significantly more detailed, which means that it is elaborated in greater depth, and includes, for instance, the most important research studies and other problems associated with the problem that is being addressed.
It might be interesting to make comparisons with other research works that have been completed more recently, particularly those that show other learning strategies and learning models that have been combined with 3D simulation tools , immersive VR.
In this particular instance, the primary contributions that the authors made to the issue that was investigated have not been very clear, nor have the benefits and drawbacks of the investigation when compared to other research that has been carried out. The number of bibliographical references incorporated in the document is not adequate. It is essential to supply a greater number of references related to virtual 3D Immersive VR technology. All of this will make it possible for us to delve deeper into the current state of the art and make comparisons with other investigations of a similar nature that have been conducted within the past few years.
In regard to the results that were presented, in order to evaluate these statistical data, it is necessary to have a deeper understanding of the sample, Do the experiments have appropriate controls? Share the VR integrated 3d IMMERSIVE SIMULATOR screenshot and mention the 3Ds Max application use case.
Author Response
Thank you for the invaluable input provided by the reviewer.
We have implemented the necessary changes in response to the reviewer's comments.
Comments and Suggestions for Authors
It is strongly recommended that the summary be rewritten in order to highlight the most important contributions and the results that were obtained. It is important to note that in recent years, the utilisation of 3D animation simulators in medical settings at a higher level has become quite commonplace.
The current state of the art is briefly discussed in both the introduction and the first topics. It is recommended that this state of the art be significantly more detailed, which means that it is elaborated in greater depth, and includes, for instance, the most important research studies and other problems associated with the problem that is being addressed.
We thank the reviewer for the comments. We have expanded on the discussion significantly to accommodate this change. We have made references to some of the critical papers and discussed the advantage and limitations in greater depth in the discussion.
It might be interesting to make comparisons with other research works that have been completed more recently, particularly those that show other learning strategies and learning models that have been combined with 3D simulation tools , immersive VR.
Thank you for your helpful comments. More recent studies have been conducted using volume rendering for temporal bone surgical simulation and generating accurate middle ear models by using the embalmed and iodine-stained human temporal bone. We have compared the advantages and disadvantages of that methodology with ours in the discussion which we have re-written to include a detailed discussion as requested.
In this particular instance, the primary contributions that the authors made to the issue that was investigated have not been very clear, nor have the benefits and drawbacks of the investigation when compared to other research that has been carried out. The number of bibliographical references incorporated in the document is not adequate. It is essential to supply a greater number of references related to virtual 3D Immersive VR technology. All of this will make it possible for us to delve deeper into the current state of the art and make comparisons with other investigations of a similar nature that have been conducted within the past few years.
In regard to the results that were presented, in order to evaluate these statistical data, it is necessary to have a deeper understanding of the sample, Do the experiments have appropriate controls? Share the VR integrated 3d IMMERSIVE SIMULATOR screenshot and mention the 3Ds Max application use case.
The reviewer raises a very important point which is the subject of current work. The focus of this study is to explore the feasibility of optimizing micro-CT data to enable the presentation of middle ear anatomy in immersive VR. We have already published on the segmentation errors that arise in threshold artefact which we have referenced in the paper (Mukherjee P, Cheng K, Chung J, Grieve SM, Solomon M, Wallace G. Precision Medicine in Ossiculoplasty. Otol Neurotol. 2021 Feb 1;42(2):e177-e185). The current paper is limited to a discussion of different rendering strategies and adaptive polygon optimisation once the segmentation has been done using our previously published protocol. We have clarified this in our methods. Since this study only uses micro-CT data, which we have already established as the ground truth, we have not used another variable as a control. Therefore, the analysis in this study focused solely on optimising the surface model to allow an optimal VR experience.
Round 2
Reviewer 2 Report
Accepted. Overall, "Human Middle Ear Anatomy Based on Micro-Computed Tomography and Reconstruction: An Immersive Virtual Reality Development" is a valuable contribution to the field of otolaryngology. Its innovative use of micro-CT and virtual reality technology provides a new level of understanding of the middle ear, which has important implications for the diagnosis and treatment of ear-related conditions.
