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Navigation as a quality management tool in cochlear implant surgery

Published online by Cambridge University Press:  08 March 2006

Jörg Schipper
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany
Antje Aschendorff
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany
Iakovos Arapakis
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany
Thomas Klenzner
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany
Christian Barna Teszler
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Bnai Zion Medical Center, Technion – Israel Institute of Technology, Haifa, Israel
Gerd Jürgen Ridder
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany
Roland Laszig
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Germany

Abstract

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.

Type
Research Article
Copyright
© 2004 Royal Society of Medicine Press

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