Visual guidance for auditory brainstem implantation with modular software design

Milovan Regodic,Wolfgang Freysinger

doi:10.1515/cdbme-2020-0044

Abstract

Abstract An auditory brainstem implant (ABI) attempts to restore hearing at patients with bilateral damaged hearing nerve. The optimal placement of the ABI is challenging even with available auditory measures on the brainstem. We present a visual guidance system that aims to assist during intraoperative ABI placement. As a starting point, a surgical probe is navigated and intuitively visualized in the microscope oculars. The system is developed using modular and agile software design techniques. In a usability study, the participants were able to detect invisible targets marked in a phantom image with a millimetric precision. To the best of our knowledge, this is the first time that this kind of visual guidance is presented. In the future, the system will be expanded with surgical instruments used for the ABI placement.

Highlights

Already for decades image-guided surgery (IGS) systems assist surgeons in accurate intraoperative navigation in interventions such as cochlear implant placement and lateral skull base surgery [1]
Correction note: Correction added on 14 April, 2021: Due to a typesetting error, reference [6] on page 2 was not linked to a reference entry and the corresponding entry was missing from the bibliography
Placing an auditory brainstem implant (ABI) on the cochlear nucleus located in the brainstem is high-risk surgery where the brainstem trauma and implant misplacements have to be avoided [2]

Summary

Introduction

Already for decades image-guided surgery (IGS) systems assist surgeons in accurate intraoperative navigation in interventions such as cochlear implant placement and lateral skull base surgery [1]. This work describes implementation of a visual guidance system in the eyepieces of a surgical microscope that aims to assist during the ABI placement. The positions are assessed by navigating the surgical probe that can be used to point the placement/implant electrode during the surgery.

Results

Conclusion