Introduction The care of patients with hearing loss with cochlear implants (CI) was very successful in recent decades. Nevertheless, the penetration of CI supply is low in patients with severe deafness. Fears of patients before surgery play a role here. These fears can be alleviated if minimally invasive procedures are used. We report the first clinical step to minimally invasive, template guided surgery. Intraoperative navigation-guided drilling in CI implantation.
Patients & Method Of 10 CI patients, the preoperative DVTs were segmented into the following anatomical structures: posterior meatus, N. facial, Chorda tympani, round window, and the Scala tympani. A trajectory became retroauricular while maintaining a safety distance to the structures. The optically navigated bore followed the trajectory. The safety distance to the structures was controlled by a classic mastoidectomy with posterior tympanotomy.
Results The segmentation of the anatomical structures succeeded. Trajectories to the round window could be planned. The preservation of the anatomical structures confirmed by the target bore was confirmed intraoperatively.
conclusion With the illustrated method of segmentation of anatomical structures, the planning of a trajectory and the resulting navigation boreholes, we were able to verify intraoperatively the reliability of segmentation, path planning and the navigated bore. This marks the first clinical milestone on the way to pre-planned and template-guided CI implantation.
Otojig GmbH Hannover
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