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  • Title: Semiautomatic cochleostomy target and insertion trajectory planning for minimally invasive cochlear implantation.
    Author: Wimmer W, Venail F, Williamson T, Akkari M, Gerber N, Weber S, Caversaccio M, Uziel A, Bell B.
    Journal: Biomed Res Int; 2014; 2014():596498. PubMed ID: 25101289.
    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.
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