A surgical navigation system for guiding exact cochleostomy using auditory feedback: a clinical feasibility study

Area of Science:

• Neurosurgery
• Otolaryngology
• Medical Device Technology

Background:

• Accurate electrode array insertion into the scala tympani is critical for successful cochlear implantation (CI) and optimal hearing outcomes.
• Current CI surgery relies heavily on surgeon skill for precise electrode placement, requiring intraoperative confirmation.
• Surgical navigation systems aim to improve accuracy and safety in complex temporal bone surgeries, but visual integration with surgical microscopes poses challenges.

Purpose of the Study:

• To evaluate the clinical feasibility of an auditory feedback system designed to guide surgeons during cochlear implantation.
• To assess the system's ability to direct surgeons to the correct cochleostomy location without compromising visual attention during surgery.
• To determine if the auditory feedback interface can reduce surgeon frustration associated with traditional surgical navigation in otologic procedures.

Main Methods:

• A clinical feasibility study was conducted involving a novel computer-surgeon interface with an auditory feedback function.
• The interface was designed to provide navigational guidance to a preset cochleostomy location during cochlear implantation surgery.
• Surgeons utilized the auditory feedback while operating under a surgical microscope to assess its effectiveness and usability.

Main Results:

• The auditory feedback system successfully guided surgeons to the correct drilling point for cochlear implantation.
• Surgeons could confirm the accuracy of the drilling location while maintaining focus on the surgical microscope.
• The proposed interface demonstrably reduced the frustration commonly experienced by surgeons using existing navigation systems in otologic surgeries.

Conclusions:

• Auditory feedback represents a feasible and effective computer-surgeon interface for guiding cochlear implantation surgery.
• This technology enhances surgical navigation by providing critical guidance without disrupting the surgeon's visual field.
• The developed system offers a promising solution to improve precision, efficiency, and surgeon experience in CI procedures.