Computer-aided surgical planning for implantation of hearing aids based on CT data in a VR environment

A study was undertaken to assess the feasibility of a preoperative fitting test for an implantable hearing aid in a virtual reality (VR) environment. High-resolution spiral computed tomography (CT) of the mastoid bone was performed, and the results of a mastoidectomy were simulated with manual segmentation on a standard medical workstation. CT was also performed on a temporal bone specimen obtained at real mastoidectomy, and the bone margins were segmented automatically with threshold-based techniques. A triangulated surface representation of the bone structures including the mastoid cavity was generated. These data as well as the computer-aided design (CAD) files of the medical devices were transferred into a VR environment. The CAD components of the hearing aid were manipulated to simulate the surgical implantation procedure. Merging CAD data of an implantable hearing aid with CT data of the temporal bone in a VR environment was shown to be a feasible method of providing three-dimensional information for the presurgical determination of fit and mountability. Advances in hardware and software are expected to improve the usability of this method. Although clinical studies are needed, these results may serve as an impetus for exploring the use of low-cost, widely available VR computer equipment in a potentially broad field of clinical applications.