Development of an intracochlear navigated electrode array for cochlear implantation
Laryngo-Rhino-Otologie, vol. 102, pp. S278
Abstract
Research question: The exact positioning of the Ci electrode in the cochlea is essential in the context of cochlear implantation. The insertion process of the electrode array during cochlear implantation represents a "black box", as direct optical visualisation is not possible. To solve this problem, a computer-assisted and image-guided system was developed to provide accurate real-time visualisation of the position of the electrode array during insertion. Methods The system is based on an electromagnetic tracking system and modified ENT navigation software and was evaluated on human petrous bone specimens. A flat-panel volume CT with a slice thickness of 100 μm was used for imaging. To validate the system, a cochlear implantation surgery was simulated. Radio-Opaque markers were inserted around the mastoid cavity for registration and accuracy measurement. After insertion, the electrode array was fixed in the cochlea and re-imaging was performed. Results In a first pilot study, the fiducial registration error (FRE) was 0.24 mm ± 0.20 mm. The prototype electrode array could be inserted into the cochlea and placed with an accuracy of 1.1 mm ± 0.40 mm. A maximum insertion angle of 120° could be achieved. Conclusion The experiments were the first step in the development of a navigated cochlear implant electrode array, which will allow intracochlear navigation to be performed. Such a system could contribute to improved control of the insertion process into the cochlea, the preoperatively defined insertion depth and avoidance of electrode malposition. Publication History Article published online: 12 May 2023 Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany
Authors 6
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Affiliation as printed
Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg
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Affiliation as printed
RWTH Aachen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
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Affiliation as printed
Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg
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Affiliation as printed
Universitätsklinikum Würzburg, Institut für Diagnostische und Interventionelle Neuroradiologie
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Technical University of Munich
Affiliation as printed
Technische Universität München, Lehrstuhl für Mikrotechnik und Medizingerätetechnik
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Technical University of Munich
Affiliation as printed
Technische Universität München, Lehrstuhl für Mikrotechnik und Medizingerätetechnik
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