Navigation as a quality management tool in cochlear implant surgery

Area of Science:

• Neurosurgery
• Otolaryngology
• Medical Technology

Background:

• Cochlear implantation is a complex surgical procedure requiring high precision.
• Navigation systems in surgery offer potential for enhanced accuracy and quality control.

Purpose of the Study:

• To evaluate the accuracy, reliability, reproducibility, and practicability of computer-assisted navigation in cochlear implant surgery using a cadaver model.
• To assess the utility of navigation as a quality management tool in this surgical context.

Main Methods:

• A cadaver study simulating cochlear implantation using the Stryker-Leibinger navigation system and Nucleus 24 Contour implant.
• Conventional surgical steps including mastoidectomy, posterior tympanotomy, and cochleostomy were performed.
• The navigated procedure was assessed for key performance metrics.

Main Results:

• Computer-assisted navigation is applicable and beneficial for quality management in cochlear implantation.
• Achieving sub-millimeter accuracy for cochleostomy requires improved referencing methods, potentially using concealed anatomical structures.
• Current navigation systems need more reproducible reference systems for reliable navigated lateral skull base surgery.

Conclusions:

• Navigation technology is a valuable, non-invasive tool for quality assurance in cochlear implant surgery.
• Enhancements in referencing techniques are crucial for improving the precision and reliability of navigated cochlear implant procedures.
• Further development is needed to fully realize the potential of navigated lateral skull base surgery.