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BioMed Research International
Volume 2014 (2014), Article ID 596498, 8 pages
http://dx.doi.org/10.1155/2014/596498
Research Article

Semiautomatic Cochleostomy Target and Insertion Trajectory Planning for Minimally Invasive Cochlear Implantation

1ARTORG Center for Biomedical Engineering Research, University of Bern, 3010 Bern, Switzerland
2Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, 3010 Bern, Switzerland
3Otology and Neurotology Department, University Hospital of Montpellier, 34961 Montpellier, France
4Institute for Neurosciences of Montpellier, INSERM U1051, 34091 Montpellier, France

Received 14 March 2014; Accepted 17 June 2014; Published 2 July 2014

Academic Editor: Claus-Peter Richter

Copyright © 2014 Wilhelm Wimmer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 ( 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.