naa a22 4500 510807100 CHVBK 20180411083423.0 cr unu---uuuuu 180411e20131101xx s 000 0 eng 10.1007/s11548-013-0842-6 doi (NATIONALLICENCE)springer-10.1007/s11548-013-0842-6 Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model [Elektronische Daten] [Theodore McRackan, Ramya Balachandran, Grégoire Blachon, Jason Mitchell, Jack Noble, Charles Wright, J. Fitzpatrick, Benoit Dawant, Robert Labadie] Purpose: Validation of a novel minimally invasive, image-guided approach to implant electrodes from three FDA-approved manufacturers—Medel, Cochlear, and Advanced Bionics—in the cochlea via a linear tunnel from the lateral cranium through the facial recess to the cochlea. Methods: Custom microstereotactic frames that mount on bone-implanted fiducial markers and constrain the drill along the desired path were utilized on seven cadaver specimens. A linear tunnel was drilled from the lateral skull to the cochlea followed by a marginal, round window cochleostomy and insertion of the electrode array into the cochlea through the drilled tunnel. Post-insertion CT scan and histological analysis were used to analyze the results. Results: All specimens ( $$N=7$$ ) were successfully implanted without visible injury to the facial nerve. The Medel electrodes ( $$N=3$$ ) had minimal intracochlear trauma with 8, 8, and 10 (out of 12) electrodes intracochlear. The Cochlear lateral wall electrodes (straight research arrays) ( $$N=2$$ ) had minimal trauma with 20 and 21 of 22 electrodes intracochlear. The Advanced Bionics electrodes ( $$N=2$$ ) were inserted using their insertion tool; one had minimal insertion trauma and 14 of 16 electrodes intracochlear, while the other had violation of the basilar membrane just deep to the cochleostomy following which it remained in scala vestibuli with 13 of 16 electrodes intracochlear. Conclusions: Minimally invasive, image-guided cochlear implantation is possible using electrodes from the three FDA-approved manufacturers. Lateral wall electrodes were associated with less intracochlear trauma suggesting that they may be better suited for this surgical technique. CARS, 2013 Cochlear implant nationallicence Minimally invasive surgery nationallicence Image-guided surgery nationallicence Microstereotactic frame nationallicence Electrode placement nationallicence McRackan Theodore Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut Balachandran Ramya Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut Blachon Grégoire Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut Mitchell Jason Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA aut Noble Jack Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut Wright Charles Department of Otolaryngology, University of Texas Southwestern, Dallas, TX, USA aut Fitzpatrick J. Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut Dawant Benoit Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut Labadie Robert Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut International Journal of Computer Assisted Radiology and Surgery Springer Berlin Heidelberg 8/6(2013-11-01), 989-995 1861-6410 8:6<989 2013 8 11548 https://doi.org/10.1007/s11548-013-0842-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11548-013-0842-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- McRackan Theodore Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut NATIONALLICENCE 700 1- Balachandran Ramya Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut NATIONALLICENCE 700 1- Blachon Grégoire Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut NATIONALLICENCE 700 1- Mitchell Jason Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA aut NATIONALLICENCE 700 1- Noble Jack Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut NATIONALLICENCE 700 1- Wright Charles Department of Otolaryngology, University of Texas Southwestern, Dallas, TX, USA aut NATIONALLICENCE 700 1- Fitzpatrick J. Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut NATIONALLICENCE 700 1- Dawant Benoit Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA aut NATIONALLICENCE 700 1- Labadie Robert Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, South Tower, 1215 21st Avenue South, 37232, Nashville, TN, USA aut NATIONALLICENCE 773 0- International Journal of Computer Assisted Radiology and Surgery Springer Berlin Heidelberg 8/6(2013-11-01), 989-995 1861-6410 8:6<989 2013 8 11548 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer