A method for accurate and reproducible specimen alignment for insertion tests of cochlear implant electrode arrays

• Published in: International journal for computer assisted radiology and surgery Vol. 19; no. 9; pp. 1883 - 1893
• Main Authors: Cramer, Jakob, Böttcher-Rebmann, Georg, Lenarz, Thomas, Rau, Thomas S.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2024; Springer Nature B.V
• Subjects: Adapters; Algorithms; Alignment; Animals; Arrays; CAD; Cochlea; Cochlea - diagnostic imaging; Cochlea - surgery; Cochlear Implantation - methods; Cochlear Implants; Computer aided design; Computer Imaging; Computer Science; Cone-Beam Computed Tomography - methods; Dissection; Electrodes; Electrodes, Implanted; Force measurement; Health Informatics; Imaging; Insertion; Medicine; Medicine & Public Health; Optics; Original Article; Pattern Recognition and Graphics; Printing, Three-Dimensional; Radiology; Registration; Reproducibility; Reproducibility of Results; Sensors; Software; Surgery; Swine; Three dimensional printing; Vision; Porcine cochlea; Pose setting adapter; Electrode insertion tests; Specimen alignment; 3D printing
• ISSN: 1861-6429; 1861-6410; 1861-6429
• DOI: 10.1007/s11548-023-02930-1

Purpose The trajectory along which the cochlear implant electrode array is inserted influences the insertion forces and the probability for intracochlear trauma. Controlling the trajectory is especially relevant for reproducible conditions in electrode insertion tests. Using ex vivo cochlear specimens, manual alignment of the invisibly embedded cochlea is imprecise and hardly reproducible. The aim of this study was to develop a method for creating a 3D printable pose setting adapter to align a specimen along a desired trajectory toward an insertion axis. Methods Planning points of the desired trajectory into the cochlea were set using CBCT images. A new custom-made algorithm processed these points for automated calculation of a pose setting adapter. Its shape ensures coaxial positioning of the planned trajectory to both the force sensor measuring direction and the insertion axis. The performance of the approach was evaluated by dissecting and aligning 15 porcine cochlear specimens of which four were subsequently used for automated electrode insertions. Results The pose setting adapter could easily be integrated into an insertion force test setup. Its calculation and 3D printing was possible in all 15 cases. Compared to planning data, a mean positioning accuracy of 0.21 ± 0.10 mm at the level of the round window and a mean angular accuracy of 0.43° ± 0.21° were measured. After alignment, four specimens were used for electrode insertions, demonstrating the practical applicability of our method. Conclusion In this work, we present a new method, which enables automated calculation and creation of a ready-to-print pose setting adapter for alignment of cochlear specimens in insertion test setups. The approach is characterized by a high level of accuracy and reproducibility in controlling the insertion trajectory. Therefore, it enables a higher degree of standardization in force measurement when performing ex vivo insertion tests and thereby improves reliability in electrode testing.