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

Wilhelm Wimmer, Frederic Venail, Tom Williamson, Mohamed Akkari, Nicolas Gerber, Stefan Weber, Marco Caversaccio, Alain Uziel, Brett Bell

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

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.

Original languageEnglish
Article number596498
JournalBioMed Research International
Volume2014
DOIs
StatePublished - 2014
Externally publishedYes

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