Automatic determination of optimal linear drilling trajectories for cochlear access accounting for drill-positioning...

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Cochlear implantation restores hearing for deaf individuals by stimulating the auditory nerve.
• Percutaneous cochlear access is a minimally invasive technique requiring a precise drilling channel.
• Pre-operative planning for safe and effective drilling trajectories is a critical challenge.

Purpose of the Study:

• To develop an automated method for determining safe and effective drilling trajectories for percutaneous cochlear access.
• To address the challenge of identifying optimal paths in pre-operative CT scans.

Main Methods:

• A Monte Carlo approach was used to quantify trajectory safety relative to sensitive anatomical structures.
• An optimization algorithm was employed to identify the drilling trajectory that maximizes safety and effectiveness.

Main Results:

• The automated technique identified approximately twice as many acceptable trajectories compared to manual methods.
• Testing was conducted on 13 human ears.

Conclusions:

• The developed method enables automatic, rapid, and consistent determination of safe drilling trajectories.
• This approach enhances the precision and safety of percutaneous cochlear implantation procedures.