Precise bonebridge implantation in challenging cases: a novel approach using virtual planning and electromagnetic...

Area of Science:

• Otolaryngology
• Neurosurgery
• Medical Device Technology

Background:

• The Bonebridge (BB) bone conduction implant is effective for children with conductive or mixed hearing loss.
• Preoperative imaging limitations can restrict safe implant placement, necessitating advanced surgical techniques.
• Navigation systems offer precision and can prevent surgical complications like dural or vascular injury.

Purpose of the Study:

• To evaluate the safety and efficacy of using Otoplan® software with a navigation system for Bonebridge (BB) implantation in children.
• To assess the accuracy of virtual implantation planning and its translation to surgical placement.
• To determine the audiological outcomes and complication rates associated with this technique.

Main Methods:

• Six pediatric patients (3-12 years) underwent BB implantation guided by Otoplan® virtual planning and navigation.
• Marker screws were placed for intraoperative cone beam CT (CBCT) registration within the navigation system.
• The planned implant position was projected onto the patient, guiding the surgical procedure.

Main Results:

• All procedures confirmed adequate bone thickness (>4.0 mm) for safe screw placement.
• No intraoperative or postoperative complications were observed up to the initial fitting (4-6 weeks).
• Audiological success, measured by speech tests, exceeded 90% in all assessable patients.

Conclusions:

• Virtual implantation using Otoplan® software, integrated with navigation systems, accurately guides screw placement for safe BB implantation.
• Navigation-guided projection enhances surgical reliability and patient safety.
• This approach represents a practical advancement for bone conduction implant surgery in pediatric cases.