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Temporal bone borehole accuracy for cochlear implantation influenced by drilling strategy: an in vitro study

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Minimally invasive cochlear implantation is a surgical technique which requires drilling a canal from the mastoid surface toward the basal turn of the cochlea. The choice of an appropriate drilling strategy is hypothesized to have significant influence on the achievable targeting accuracy. Therefore, a method is presented to analyze the contribution of the drilling process and drilling tool to the targeting error isolated from other error sources.

Methods

The experimental setup to evaluate the borehole accuracy comprises a drill handpiece attached to a linear slide as well as a highly accurate coordinate measuring machine (CMM). Based on the specific requirements of the minimally invasive cochlear access, three drilling strategies, mainly characterized by different drill tools, are derived. The strategies are evaluated by drilling into synthetic temporal bone substitutes containing air-filled cavities to simulate mastoid cells. Deviations from the desired drill trajectories are determined based on measurements using the CMM.

Results

Using the experimental setup, a total of 144 holes were drilled for accuracy evaluation. Errors resulting from the drilling process depend on the specific geometry of the tool as well as the angle at which the drill contacts the bone surface. Furthermore, there is a risk of the drill bit deflecting due to synthetic mastoid cells.

Conclusions

A single-flute gun drill combined with a pilot drill of the same diameter provided the best results for simulated minimally invasive cochlear implantation, based on an experimental method that may be used for testing further drilling process improvements.

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Acknowledgments

The authors would like to thank Robert F. Labadie, MD, Ph.D. and Ramya Balachandran, Ph.D. (Vanderbilt University Medical Center, Nashville, TN, USA) for gratefully providing comprehensive information on the drill bits used in their studies. The co-author Thomas S. Rau would like to thank Prof. Witte (Ilmenau University of Technology, Ilmenau, Germany) for the motivating and guiding discussion about industrial deep-hole drilling and its transfer to clinical application. This work was funded by the German Research Foundation (DFG). The project numbers are OR 196/10-1 and MA 4038/6-1. Responsibility for the contents of this publication lies with the authors.

Conflict of interest

Jan-Philipp Kobler, Michael Schoppe, G. Jakob Lexow, Thomas S. Rau, Omid Majdani, Lüder A. Kahrs and Tobias Ortmaier declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Mechatronic Systems, Leibniz Universität Hannover, 30167 , Hannover, Germany

    Jan-Philipp Kobler, Michael Schoppe, Lüder A. Kahrs & Tobias Ortmaier

  2. Hannover Medical School, 30625 , Hannover, Germany

    G. Jakob Lexow, Thomas S. Rau & Omid Majdani

Authors
  1. Jan-Philipp Kobler
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  2. Michael Schoppe
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  3. G. Jakob Lexow
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  4. Thomas S. Rau
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  5. Omid Majdani
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  6. Lüder A. Kahrs
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  7. Tobias Ortmaier
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Correspondence to Jan-Philipp Kobler.

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Kobler, JP., Schoppe, M., Lexow, G.J. et al. Temporal bone borehole accuracy for cochlear implantation influenced by drilling strategy: an in vitro study. Int J CARS 9, 1033–1043 (2014). https://doi.org/10.1007/s11548-014-0997-9

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  • DOI: https://doi.org/10.1007/s11548-014-0997-9

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