TY - JOUR
T1 - Cochlear implant positioning and fixation using 3D-printed patient specific surgical guides; a cadaveric study
AU - Markodimitraki, Laura M.
AU - ten Harkel, Timen C.
AU - Bleys, Ronald L. A. W.
AU - Stegeman, Inge
AU - Thomeer, Hans G. X. M.
N1 - Funding Information: Oticon Medical directly funds the PhD research project of LM, via the University Medical Center Utrecht. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to thank the 3D Face Lab of the Department of Oral and Maxillofacial Surgery at the UMC Utrecht for technical advice and support, and the Department of Anatomy at the UMC Utrecht for supporting this research. Publisher Copyright: Copyright: © 2022 Markodimitraki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/7
Y1 - 2022/7
N2 - Hypothesis To develop and validate the optimal design and evaluate accuracy of individualized 3D-printed surgical guides for cochlear implantation. Background Positioning and fixation of the cochlear implant (CI) are commonly performed free hand. Applications of 3-dimensional (3D) technology now allow us to make patient specific, bone supported surgical guides, to aid CI surgeons with precise placement and drilling out the bony well which accommodates the receiver/stimulator device of the CI. Methods Cone beam CT (CBCT) scans were acquired from temporal bones in 9 cadaveric heads (18 ears), followed by virtual planning of the CI position. Surgical, bone-supported drilling guides were designed to conduct a minimally invasive procedure and were 3D-printed. Fixation screws were used to keep the guide in place in predetermined bone areas. Specimens were implanted with 3 different CI models. After implantation, CBCT scans of the implanted specimens were performed. Accuracy of CI placement was assessed by comparing the 3D models of the planned and implanted CI’s by calculating the translational and rotational deviations. Results Median translational deviations of placement in the X- and Y-axis were within the predetermined clinically relevant deviation range (< 3 mm per axis); median translational deviation in the Z-axis was 3.41 mm. Median rotational deviations of placement for X-, Y- and Z-rotation were 5.50°, 4.58° and 3.71°, respectively. Conclusion This study resulted in the first 3D-printed, patient- and CI- model specific surgical guide for positioning during cochlear implantation. The next step for the development and evaluation of this surgical guide will be to evaluate the method in clinical practice.
AB - Hypothesis To develop and validate the optimal design and evaluate accuracy of individualized 3D-printed surgical guides for cochlear implantation. Background Positioning and fixation of the cochlear implant (CI) are commonly performed free hand. Applications of 3-dimensional (3D) technology now allow us to make patient specific, bone supported surgical guides, to aid CI surgeons with precise placement and drilling out the bony well which accommodates the receiver/stimulator device of the CI. Methods Cone beam CT (CBCT) scans were acquired from temporal bones in 9 cadaveric heads (18 ears), followed by virtual planning of the CI position. Surgical, bone-supported drilling guides were designed to conduct a minimally invasive procedure and were 3D-printed. Fixation screws were used to keep the guide in place in predetermined bone areas. Specimens were implanted with 3 different CI models. After implantation, CBCT scans of the implanted specimens were performed. Accuracy of CI placement was assessed by comparing the 3D models of the planned and implanted CI’s by calculating the translational and rotational deviations. Results Median translational deviations of placement in the X- and Y-axis were within the predetermined clinically relevant deviation range (< 3 mm per axis); median translational deviation in the Z-axis was 3.41 mm. Median rotational deviations of placement for X-, Y- and Z-rotation were 5.50°, 4.58° and 3.71°, respectively. Conclusion This study resulted in the first 3D-printed, patient- and CI- model specific surgical guide for positioning during cochlear implantation. The next step for the development and evaluation of this surgical guide will be to evaluate the method in clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=85135281892&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0270517
DO - https://doi.org/10.1371/journal.pone.0270517
M3 - Article
C2 - 35877605
SN - 1932-6203
VL - 17
SP - e0270517
JO - PLOS ONE
JF - PLOS ONE
IS - 7 July
M1 - e0270517
ER -