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Variability of the mental representation of the cochlear anatomy during cochlear implantation

  • Otology
  • Published:
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Abstract

The aim of this study was to assess the mental representation of the insertion axis of surgeons with different degrees of experience, and reproducibility of the insertion axis in repeated measures. A mastoidectomy and a posterior tympanotomy were prepared in five different artificial temporal bones. A cone-beam CT was performed for each temporal bone and the data were registered on a magnetic navigation system. In these five temporal bones, 16 surgeons (3 experts; >50 cochlear implant surgery/year; 7 fellows with few cochlear implant experience, and 6 residents) were asked to determine the optimal insertion axis according to their mental representation. Compared to a planned ideal axis, the insertion axis was better determined by the experts with higher accuracy (axial: 7° ± 1.5°, coronal: 6° ± 1.5°) than fellows (axial: 14° ± 1.7°, coronal: 13° ± 1.7°; p < 0.05), or residents (axial: 15° ± 1.5°; p < 0.001, coronal: 17° ± 1.9°; p < 0.001). This study suggests that mental representation of the cochlea is experience-dependent. A high variation of the insertion axis to the scala tympani can be observed due to the complexity of the temporal bone anatomy and lack of landmarks to determine scala tympani orientation. Navigation systems can be used to evaluate and improve mental representation of the insertion axis to the scala tympani for cochlear implant surgery.

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Acknowledgments

The authors would like to thank all the surgeons for their participation in this evaluation.

Author information

Authors and Affiliations

  1. Unit of Otology, Auditory Implants and Skull Base Surgery, Otorhinolaryngology Department, Pitié-Salpêtrière Hospital, AP-HP, Bâtiment Castaigne, 47-83 boulevard de l’Hôpital, 75651, Paris Cedex 13, France

    Renato Torres, Daniele Bernardeschi, Daniele De Seta, Evelyne Ferrary, Olivier Sterkers & Yann Nguyen

  2. UPMC Univ. Paris 06, Sorbonne University, Paris, France

    Renato Torres, Guillaume Kazmitcheff, Daniele Bernardeschi, Daniele De Seta, Evelyne Ferrary, Olivier Sterkers & Yann Nguyen

  3. “Minimally Invasive Robot-based Hearing Rehabilitation”, UMR-S 1159, Paris 6 UMPC Univ, Inserm, Paris, France

    Renato Torres, Guillaume Kazmitcheff, Daniele Bernardeschi, Daniele De Seta, Jean Loup Bensimon, Evelyne Ferrary, Olivier Sterkers & Yann Nguyen

  4. Shacra Inria, Lille Nord-Europe, Université Lille-1, Lille, France

    Guillaume Kazmitcheff

  5. Department of Sense Organs, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy

    Daniele De Seta

  6. Cabinet de Radiologie, 106 bis Rue de Lourmel, 75015, Paris, France

    Jean Loup Bensimon

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  1. Renato Torres
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  2. Guillaume Kazmitcheff
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  3. Daniele Bernardeschi
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  4. Daniele De Seta
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  8. Yann Nguyen
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Correspondence to Yann Nguyen.

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Torres, R., Kazmitcheff, G., Bernardeschi, D. et al. Variability of the mental representation of the cochlear anatomy during cochlear implantation. Eur Arch Otorhinolaryngol 273, 2009–2018 (2016). https://doi.org/10.1007/s00405-015-3763-x

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  • DOI: https://doi.org/10.1007/s00405-015-3763-x

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