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The accuracy of image-based safety analysis for robotic cochlear implantation

  • C. Rathgeb
  • F. Wagner
  • W. WimmerEmail author
  • N. Gerber
  • T. Williamson
  • L. Anschütz
  • S. Weder
  • M. Stadelmann
  • G. Braga
  • J. Anso
  • M. Caversaccio
  • S. Weber
  • K. Gavaghan
Original Article
  • 229 Downloads

Abstract

Purpose

To evaluate the accuracy and reliability of image-based safety analysis for robotic cochlear implantation (RCI) in an ex vivo assessment.

Methods

The accuracy was evaluated in a study on 23 human temporal bones. For image analysis, a computer-assisted safety analysis based on intraoperative cone beam computed tomography was implemented. The method automatically segments the drill tunnel and predicts the distance between the tunnel and the facial nerve. In addition, the drilling error at the target is predicted. The predicted distances were compared with the actually drilled distances measured in postoperative high-resolution micro-computed tomography scans. The automatic method was compared to accuracies associated with a manual analysis of the image data.

Results

The presented computerized image-based analysis enabled the proximity of the facial nerve to the drill trajectory to be predicted with an accuracy of 0.22 ± 0.15 mm and drilling error at the target to be predicted with an accuracy of 0.11 mm ± 0.08 during N = 19 RCI procedures. The manual assessment of facial nerve proximity was performed with an accuracy of 0.34 ± 0.20 mm by a trained clinical expert.

Conclusion

The assessment of intraoperative CT-based imaging presents multiple benefits over alternative safety mechanisms including early detection and applicability even in cases of malformation of the mastoid. This work presents a computer-assisted approach to image analysis that enables procedure safety measurements to be reliably performed with superior accuracy to other proposed safety methodologies, at a safe distance from the facial nerve. Its application must, however, be considered in relation to associated costs (time, cost, irradiation) and the dependence of the measure on a reliable preoperative segmentation.

Keywords

Robotic cochlear implantation Intraoperative imaging Safety mechanism 

Notes

Funding

This study was funded by the Commission for Technology and Innovation KTI, Switzerland (176181).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The ex vivo study was approved by the local institutional review board (KEK-BE 2016-00887).

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Copyright information

© CARS 2018

Authors and Affiliations

  • C. Rathgeb
    • 1
  • F. Wagner
    • 2
  • W. Wimmer
    • 1
    • 3
    Email author
  • N. Gerber
    • 4
  • T. Williamson
    • 4
  • L. Anschütz
    • 3
  • S. Weder
    • 3
  • M. Stadelmann
    • 5
  • G. Braga
    • 4
  • J. Anso
    • 4
  • M. Caversaccio
    • 1
    • 3
  • S. Weber
    • 4
  • K. Gavaghan
    • 4
  1. 1.Hearing Research Laboratory, ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
  2. 2.Department of Diagnostic and Interventional Neuroradiology, Inselspital, University HospitalUniversity of BernBernSwitzerland
  3. 3.Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University HospitalUniversity of BernBernSwitzerland
  4. 4.Image Guided Therapy, ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
  5. 5.Institute for Surgical Technology and BiomechanicsUniversity of BernBernSwitzerland

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