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77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

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Hexapod-based drilling guidance for a navigated cochleostomy

Hexapod-gestützte Bohrerführung für eine navigierte Cochleostomie

Meeting Abstract

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  • corresponding author presenting/speaker Felix Bernhard Knapp - Department of ORL & HNS, University Hospital, Freiburg, Germany
  • Chiu Chun Ngan - Institute for Process Control and Robotics, University of Karlsruhe, Karlsruhe, Germany
  • Jörg Schipper - Department of ORL & HNS, University Hospital, Freiburg, Germany
  • Jan Kromeier - Department of Radiology, University Hospital, Freiburg, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno018

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno018.shtml

Published: September 7, 2006

© 2006 Knapp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: The temporal bone with its complex anatomy represents a special challenge to the spatial imagination of the surgeon. A highly precise cochleostomy is required to conserve existing inner ear functions. A hexapod-based and navigated instrument guidance could represent a convincing solution for the demanded accuracy.

Methods: On three human temporal bones a regular mastoidectomy with a posterior tympanotomy was performed preserving the chorda tympani. Four titanium screw markers were drilled into the bone. The open-source Dicom-viewer OsiriX was modified to generate automatically a 3D-model with the dataset of a 64 CT scanner (Siemens Sensation). Therein, the surgeon was able to define and mark the point of cochleostomy. With the aid of the 3D-model a trajectory towards the cochleostomy could be planned. A drill fixed onto the hexapod has been used and navigated for the cochleostomy via the posterior cochleostomy.

Results: In the virtual 3D-model the surgeon is able to define the point of cochleostomy with the appropriate allocation on its axial CT-slices. A path free of collision was reached. The scala tympani was opened up.

Conclusion: In the future, the combination of a virtual 3D-model with a hexapod-kinematic could offer the possibility of a highly precise and navigated cochleostomy.

This study was supported by the Federal Ministry of Education and Research of Germany and the companies Cochlear GmbH und Richard Wolf GmbH, Germany.