A new method to determine the optimal orientation of Slim Modiolar cochlear implant electrode array insertion

Area of Science:

• Neurosurgery
• Biomedical Engineering
• Medical Imaging

Background:

• Electrode array insertion in cochlear implant surgery can be challenging, leading to complications like buckling or tip fold-over.
• Unfavorable electrode orientation is a potential cause of these surgical complications.
• A standardized, easy-to-use method is needed to guide optimal Slim Modiolar electrode insertion.

Purpose of the Study:

• To determine the optimal insertion orientation for the Slim Modiolar electrode.
• To develop a practical method for aiding cochlear implant surgery.
• To reduce surgical complications associated with electrode array insertion.

Main Methods:

• Utilized preoperative CT scans of cochlear implant patients.
• Employed 3D Slicer software for image visualization and landmark identification (incus short process).
• Developed a Python code to calculate the optimal insertion angle based on anatomical landmarks and the electrode's orientation marker (winglet).

Main Results:

• The developed algorithm calculated an optimal insertion angle of 46.6055°.
• 3D reconstruction and validation using ImageJ confirmed the angle with high precision (46.599°).
• The method allows for patient-specific surgical planning based on routine CT scans.

Conclusions:

• The developed method is easy, fast, and time-efficient for surgical planning.
• Individualized planning enhances the safety of cochlear implantation procedures.
• The method is intended for future use in all Slim Modiolar electrode surgeries.