Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model

Theodore R. McRackan, Ramya Balachandran, Grégoire S. Blachon, Jason E. Mitchell, Jack H. Noble, Charles G. Wright, J. Michael Fitzpatrick, Benoit M. Dawant, Robert F. Labadie

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)989-995
Number of pages7
JournalInternational journal of computer assisted radiology and surgery
Volume8
Issue number6
DOIs
StatePublished - Nov 2013

Fingerprint

Bionics
Cochlear Implantation
Cochlea
Cadaver
Electrodes
Tunnels
Wounds and Injuries
Skull
Scala Vestibuli
Facial Nerve Injuries
Fiducial Markers
Basilar Membrane
Mandrillus
Computerized tomography

Keywords

  • Cochlear implant
  • Electrode placement
  • Image-guided surgery
  • Microstereotactic frame
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Health Informatics
  • Surgery

Cite this

Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model. / McRackan, Theodore R.; Balachandran, Ramya; Blachon, Grégoire S.; Mitchell, Jason E.; Noble, Jack H.; Wright, Charles G.; Fitzpatrick, J. Michael; Dawant, Benoit M.; Labadie, Robert F.

In: International journal of computer assisted radiology and surgery, Vol. 8, No. 6, 11.2013, p. 989-995.

Research output: Contribution to journalArticle

McRackan, Theodore R. ; Balachandran, Ramya ; Blachon, Grégoire S. ; Mitchell, Jason E. ; Noble, Jack H. ; Wright, Charles G. ; Fitzpatrick, J. Michael ; Dawant, Benoit M. ; Labadie, Robert F. / Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model. In: International journal of computer assisted radiology and surgery. 2013 ; Vol. 8, No. 6. pp. 989-995.
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T1 - Validation of minimally invasive, image-guided cochlear implantation using Advanced Bionics, Cochlear, and Medel electrodes in a cadaver model

AU - McRackan, Theodore R.

AU - Balachandran, Ramya

AU - Blachon, Grégoire S.

AU - Mitchell, Jason E.

AU - Noble, Jack H.

AU - Wright, Charles G.

AU - Fitzpatrick, J. Michael

AU - Dawant, Benoit M.

AU - Labadie, Robert F.

PY - 2013/11

Y1 - 2013/11

N2 - 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.

AB - 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.

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KW - Electrode placement

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KW - Microstereotactic frame

KW - Minimally invasive surgery

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