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Investigating variability in cochlear implant electrode array alignment and the potential of visualization guidance
Author(s) -
Yasin Rashid,
Dedmon Matthew,
Dillon Neal,
Simaan Nabil
Publication year - 2019
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2009
Subject(s) - cochlear implant , visualization , orientation (vector space) , electrode array , repeatability , computer science , metric (unit) , sensory cue , visual inspection , software , implant , cochlear implantation , computer vision , biomedical engineering , audiology , artificial intelligence , electrode , medicine , surgery , engineering , mathematics , chemistry , statistics , operations management , programming language , geometry
Background Internal cochlear anatomy is difficult to discern from external inspection, hindering cochlear implant electrode insertion. Methods A user study characterized the repeatability of standard surgical technique and examined the role of visual inspection and guidance cues in reducing electrode array insertion misalignment. Results Without guidance, a large spread in angles of insertion, up to 30°, was observed, highlighting the need for intraoperative guidance. Visual inspection did not significantly improve overall orientation, suggesting the need for alternate intracochlear visualization methods and/or increased training to effectively improve surgeon understanding of the visualized images. Visual cues and guidance software increased repeatability of surgeon performance, reducing one metric of repeatability to ±2°. Conclusions This study establishes a baseline for surgeon variability in cochlear implant insertion and supports the need and lays the groundwork for future intraoperative guidance techniques.