Navigation as a quality management tool in cochlear implant surgery
Jörg Schipper M.D. a1, Antje Aschendorff M.D. a1, Iakovos Arapakis M.D. a1, Thomas Klenzner M.D. a1, Christian Barna Teszler M.D. a2, Gerd Jürgen Ridder M.D. a1andRoland Laszig M.D. a1 a1 Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany a2 Department of Otorhinolaryngology, Head and Neck Surgery, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
This cadaver study assessed the value of navigation in cochlear implant surgery. Cochlear implantation was simulated on a cadaver using a Stryker-Leibinger navigation system and a Nucleus 24 Contour implant. A conventional surgical strategy consisting of mastoidectomy, posterior tympanotomy, and cochleostomy was performed. The navigated surgical procedure was evaluated for accuracy, reliability, reproducibility, and practicability. The technology of computer-assisted surgery is applicable in cochlear implantation and beneficial in as much as the navigation-controlled implantation constitutes a non-invasive instrument of quality management. Nevertheless, in order to keep the point accuracy below one millimeter, a referencing methodusing concealed bordering anatomical structures may be further needed to perform the cochleostomy reliably under the guidance of a navigation system. More reproducible reference systems are needed if navigated lateral skull base surgery is to be fully relied upon.