Semiautomatic cochleostomy target and insertion trajectory planning for minimally invasive cochlear implantation

Biomed Res Int. 2014:2014:596498. doi: 10.1155/2014/596498. Epub 2014 Jul 2.

Abstract

A major component of minimally invasive cochlear implantation is atraumatic scala tympani (ST) placement of the electrode array. This work reports on a semiautomatic planning paradigm that uses anatomical landmarks and cochlear surface models for cochleostomy target and insertion trajectory computation. The method was validated in a human whole head cadaver model (n = 10 ears). Cochleostomy targets were generated from an automated script and used for consecutive planning of a direct cochlear access (DCA) drill trajectory from the mastoid surface to the inner ear. An image-guided robotic system was used to perform both, DCA and cochleostomy drilling. Nine of 10 implanted specimens showed complete ST placement. One case of scala vestibuli insertion occurred due to a registration/drilling error of 0.79 mm. The presented approach indicates that a safe cochleostomy target and insertion trajectory can be planned using conventional clinical imaging modalities, which lack sufficient resolution to identify the basilar membrane.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basilar Membrane / pathology
  • Basilar Membrane / surgery
  • Cochlea / pathology
  • Cochlea / surgery*
  • Cochlear Implantation / methods*
  • Humans
  • Minimally Invasive Surgical Procedures / methods*
  • Software
  • Surgery, Computer-Assisted / methods*