European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 7, pp 1651–1658 | Cite as

Topographic bone thickness maps for Bonebridge implantations

  • Wilhelm Wimmer
  • Nicolas GerberEmail author
  • Jérémie Guignard
  • Patrick Dubach
  • Martin Kompis
  • Stefan Weber
  • Marco Caversaccio


Bonebridge™ (BB) implantation relies on optimal anchoring of the bone-conduction implant in the temporal bone. Preoperative position planning has to account for the available bone thickness minimizing unwanted interference with underlying anatomical structures. This study describes the first clinical experience with a planning method based on topographic bone thickness maps (TBTM) for presigmoid BB implantations. The temporal bone was segmented enabling three-dimensional surface generation. Distances between the external and internal surface were color encoded and mapped to a TBTM. Suitable implant positions were planned with reference to the TBTM. Surgery was performed according to the standard procedure (n = 7). Computation of the TBTM and consecutive implant position planning took 70 min on average for a trained technician. Surgical time for implantations under passive TBTM image guidance was 60 min, on average. The sigmoid sinus (n = 5) and dura mater (n = 1) were exposed, as predicted with the TBTM. Feasibility of the TBTM method was shown for standard presigmoid BB implantations. The projection of three-dimensional bone thickness information into a single topographic map provides the surgeon with an intuitive display of the anatomical situation prior to implantation. Nevertheless, TBTM generation time has to be significantly reduced to simplify integration in clinical routine.


Bone-conduction implants Preoperative planning Temporal bone Passive image guidance 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Wilhelm Wimmer
    • 1
  • Nicolas Gerber
    • 1
    Email author
  • Jérémie Guignard
    • 1
  • Patrick Dubach
    • 2
    • 3
  • Martin Kompis
    • 2
  • Stefan Weber
    • 1
  • Marco Caversaccio
    • 2
  1. 1.ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
  2. 2.Department of Otorhinolaryngology Head and Neck SurgeryInselspital, University of BernBernSwitzerland
  3. 3.BMBF, Innovation Center for Computer Aided Surgery (ICCAS)University of LeipzigLeipzigGermany

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