Related Experiment Video
Updated: Jan 13, 2026
Enhancing Electrode Location Assessment in Cochlear Implantation via Computed Tomography Image Fusion
Published on: January 17, 2025
A clinical shift toward personalized cochlear implantation: Using preoperative planning to optimize insertion depth.
Benjamin Bircher1, Philipp Aebischer1, Wilhelm Wimmer2
1Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland; Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Preoperative planning for cochlear implant electrode selection improves insertion depth and consistency. Shorter cochlear duct length and intraoperative resistance were linked to insertion inaccuracies, not deeper targets.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Imaging
Background:
- Cochlear implantation aims to restore hearing by stimulating the auditory nerve with an electrode array.
- Accurate electrode placement is crucial for optimal audiological outcomes.
- Preoperative planning can optimize electrode selection and surgical approach.
Purpose of the Study:
- To assess the clinical use of preoperative, anatomy-tailored planning for cochlear implant electrode selection.
- To quantify the accuracy of this planning method in routine practice.
- To identify factors influencing deviations from the planned angular insertion depth (AID).
Main Methods:
- Retrospective analysis of 54 cochlear implantations.
- Comparison between surgeon preference (Group A) and automated OTOPLAN-based planning (Group B).
- Analysis of pre- and postoperative CT scans for cochlear metrics and achieved AID; speech outcomes at 6 months.
Main Results:
- Automated planning (Group B) resulted in deeper and more consistent insertions (median AID 568°) compared to surgeon preference (Group A, 527°).
- Median planning deviation was -9°, with no correlation to planned depth.
- Inaccuracies were associated with shorter cochlear duct length (CDL) and intraoperative resistance.
Conclusions:
- Anatomy-tailored preoperative planning facilitates selection of longer arrays and achieves deeper, more consistent electrode insertions.
- Planning accuracy is high, with deviations mainly linked to patient-specific anatomy (shorter CDL) and surgical factors (resistance).
- Routine, examiner-independent planning is feasible and supports using patient-specific anatomy to guide electrode array selection.
