Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro
Background: A single drilled tunnel from the lateral mastoid cortex to the cochlea via the facial recess is essential for minimally invasive cochlear implant surgery. This study aimed to explore the safety profile of this kind of new image-guided and bi-planar device-assisted surgery procedure in vi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2016-01-01
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| Series: | Chinese Medical Journal |
| Subjects: | |
| Online Access: | http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=20;spage=2476;epage=2483;aulast=Ke |
| _version_ | 1818150193487413248 |
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| author | Jia Ke Shao-Xing Zhang Lei Hu Chang-Sheng Li Yun-Feng Zhu Shi-Long Sun Li-Feng Wang Fu-Rong Ma |
| author_facet | Jia Ke Shao-Xing Zhang Lei Hu Chang-Sheng Li Yun-Feng Zhu Shi-Long Sun Li-Feng Wang Fu-Rong Ma |
| author_sort | Jia Ke |
| collection | DOAJ |
| description | Background: A single drilled tunnel from the lateral mastoid cortex to the cochlea via the facial recess is essential for minimally invasive cochlear implant surgery. This study aimed to explore the safety profile of this kind of new image-guided and bi-planar device-assisted surgery procedure in vitro.
Methods: Image-guided minimally invasive cochlear implantations were performed on eight cadaveric temporal bone specimens. The main procedures were: (1) temporal bone specimens were prepared for surgery and fiducial markers were registered. (2) computed tomography (CT) scans were performed for future reference. (3) CT scan images were processed and drill path was planned to minimize cochlear damage. (4) bi-planar device-assisted drilling was performed on the specimens using the registration. (5) surgical safety was evaluated by calculating the deviation between the drill and the planned paths, and by measuring the closest distance between the drilled path and critical anatomic structures.
Results: Eight cases were operated successfully to the basal turn of the cochlear with intact facial nerves (FNs). The deviations from target points and entrance points were 0.86 mm (0.68-1.00 mm) and 0.44 mm (0.30-0.96 mm), respectively. The angular error between the planned and the drilled trajectory was 1.74° (1.26-2.41°). The mean distance from the edge of the drilled path to the FN and to the external canal was 0.60 mm (0.35-0.83 mm) and 1.60 mm (1.30-2.05 mm), respectively. In five specimens, the chorda tympani nerves were well preserved. In all cases, no injury happened to auditory ossicles.
Conclusions: This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational procedures. Further, more in vitro experiments are needed to improve the system operation and its safety. |
| first_indexed | 2024-12-11T13:19:02Z |
| format | Article |
| id | doaj.art-5b740158602b49ce91481ea09ea4700b |
| institution | Directory Open Access Journal |
| issn | 0366-6999 |
| language | English |
| last_indexed | 2024-12-11T13:19:02Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-5b740158602b49ce91481ea09ea4700b2022-12-22T01:05:55ZengWolters KluwerChinese Medical Journal0366-69992016-01-01129202476248310.4103/0366-6999.191787Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitroJia KeShao-Xing ZhangLei HuChang-Sheng LiYun-Feng ZhuShi-Long SunLi-Feng WangFu-Rong MaBackground: A single drilled tunnel from the lateral mastoid cortex to the cochlea via the facial recess is essential for minimally invasive cochlear implant surgery. This study aimed to explore the safety profile of this kind of new image-guided and bi-planar device-assisted surgery procedure in vitro. Methods: Image-guided minimally invasive cochlear implantations were performed on eight cadaveric temporal bone specimens. The main procedures were: (1) temporal bone specimens were prepared for surgery and fiducial markers were registered. (2) computed tomography (CT) scans were performed for future reference. (3) CT scan images were processed and drill path was planned to minimize cochlear damage. (4) bi-planar device-assisted drilling was performed on the specimens using the registration. (5) surgical safety was evaluated by calculating the deviation between the drill and the planned paths, and by measuring the closest distance between the drilled path and critical anatomic structures. Results: Eight cases were operated successfully to the basal turn of the cochlear with intact facial nerves (FNs). The deviations from target points and entrance points were 0.86 mm (0.68-1.00 mm) and 0.44 mm (0.30-0.96 mm), respectively. The angular error between the planned and the drilled trajectory was 1.74° (1.26-2.41°). The mean distance from the edge of the drilled path to the FN and to the external canal was 0.60 mm (0.35-0.83 mm) and 1.60 mm (1.30-2.05 mm), respectively. In five specimens, the chorda tympani nerves were well preserved. In all cases, no injury happened to auditory ossicles. Conclusions: This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational procedures. Further, more in vitro experiments are needed to improve the system operation and its safety.http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=20;spage=2476;epage=2483;aulast=KeCochlear Implantation; Minimally Invasive Surgical Procedures; Navigation |
| spellingShingle | Jia Ke Shao-Xing Zhang Lei Hu Chang-Sheng Li Yun-Feng Zhu Shi-Long Sun Li-Feng Wang Fu-Rong Ma Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro Chinese Medical Journal Cochlear Implantation; Minimally Invasive Surgical Procedures; Navigation |
| title | Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro |
| title_full | Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro |
| title_fullStr | Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro |
| title_full_unstemmed | Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro |
| title_short | Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro |
| title_sort | minimally invasive cochlear implantation assisted by bi planar device an exploratory feasibility study in vitro |
| topic | Cochlear Implantation; Minimally Invasive Surgical Procedures; Navigation |
| url | http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=20;spage=2476;epage=2483;aulast=Ke |
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