title: Navigation as a quality management tool in cochlear implant surgery.
abstract: This cadaver study assessed the value of navigation in cochlear implant surgery. Cochlear implantation was simulated on a cadaver using a Stryker-Leibinger navigation system and a Nucleus 24 Contour implant. A conventional surgical strategy consisting of mastoidectomy, posterior tympanotomy, and cochleostomy was performed. The navigated surgical procedure was evaluated for accuracy, reliability, reproducibility, and practicability. The technology of computer-assisted surgery is applicable in cochlear implantation and beneficial in as much as the navigation-controlled implantation constitutes a non-invasive instrument of quality management. Nevertheless, in order to keep the point accuracy below one millimeter, a referencing method using concealed bordering anatomical structures may be further needed to perform the cochleostomy reliably under the guidance of a navigation system. More reproducible reference systems are needed if navigated lateral skull base surgery is to be fully relied upon.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical School, Killianstrasse 5, 79106 Freiburg, Germany. schipper@hno.ukl.uni-freiburg.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Schipper
authors.forename: Antje
authors.initials: A
authors.lastname: Aschendorff
authors.forename: Iakovos
authors.initials: I
authors.lastname: Arapakis
authors.forename: Thomas
authors.initials: T
authors.lastname: Klenzner
authors.forename: Christian Barna
authors.initials: CB
authors.lastname: Teszler
authors.forename: Gerd Jürgen
authors.initials: GJ
authors.lastname: Ridder
authors.forename: Roland
authors.initials: R
authors.lastname: Laszig
mesh_terms: D002102:Cadaver; D003054:Cochlear Implants; D006801:Humans; D038361:Neuronavigation; D011787:Quality of Health Care; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods