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

Abstract EN

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.