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Cochlear implant positioning and fixation using 3D-printed patient specific surgical guides; a cadaveric study
Laura M Markodimitraki1,2, Timen C Ten Harkel3, Ronald L A W Bleys4
1Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Plos One
|July 25, 2022
Summary
This study introduces patient-specific, 3D-printed surgical guides for precise cochlear implant (CI) placement, improving accuracy in a cadaver model. Further clinical evaluation is planned.
Area of Science:
- Biomedical Engineering
- Surgical Technology
- Otolaryngology
Background:
- Cochlear implantation (CI) positioning is often freehand, risking imprecise placement.
- 3D technology enables patient-specific, bone-supported surgical guides for enhanced CI accuracy.
- These guides aid surgeons in precise placement and drilling for the CI receiver/stimulator.
Purpose of the Study:
- To develop and validate an optimal design for individualized 3D-printed surgical guides.
- To evaluate the accuracy of these patient-specific guides in cochlear implantation.
- To establish a novel method for precise CI device positioning.
Main Methods:
- Cone beam CT (CBCT) scans of 9 cadaveric temporal bones (18 ears).
- Virtual planning of CI position and design of 3D-printed, bone-supported surgical guides.
- Guide fixation with screws, implantation of 3 CI models, post-implantation CBCT, and deviation analysis (translational and rotational).
Main Results:
- Median translational deviations were within 3 mm for X and Y axes, with 3.41 mm for the Z axis.
- Median rotational deviations were 5.50° (X), 4.58° (Y), and 3.71° (Z).
- The developed guides demonstrated accuracy in positioning the cochlear implant in a cadaveric model.
Conclusions:
- The study successfully developed the first 3D-printed, patient- and CI-model specific surgical guide for cochlear implantation.
- The guide facilitates precise positioning and drilling for CI placement.
- Clinical practice evaluation is the recommended next step for this novel surgical guide.
