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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
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Abstract

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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