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Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Völker J, Hagen R, Rak K. Comprehensive literature review on the application of the otological surgical planning software OTOPLAN® for cochlear implantation. HNO 2024:10.1007/s00106-023-01417-4. [PMID: 38861031 DOI: 10.1007/s00106-023-01417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 06/12/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
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Affiliation(s)
- Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany.
| | - Björn Spahn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - David P Herrmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Johannes Völker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
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Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Voelker J, Hagen R, Rak K. [Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN® for cochlear implantation. German version]. HNO 2024:10.1007/s00106-024-01461-8. [PMID: 38587661 DOI: 10.1007/s00106-024-01461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
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Affiliation(s)
- Franz-Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - David P Herrmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Anja Kurz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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Khurana L, Harczos T, Moser T, Jablonski L. En route to sound coding strategies for optical cochlear implants. iScience 2023; 26:107725. [PMID: 37720089 PMCID: PMC10502376 DOI: 10.1016/j.isci.2023.107725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Hearing loss is the most common human sensory deficit. Severe-to-complete sensorineural hearing loss is often treated by electrical cochlear implants (eCIs) bypassing dysfunctional or lost hair cells by direct stimulation of the auditory nerve. The wide current spread from each intracochlear electrode array contact activates large sets of tonotopically organized neurons limiting spectral selectivity of sound coding. Despite many efforts, an increase in the number of independent eCI stimulation channels seems impossible to achieve. Light, which can be better confined in space than electric current may help optical cochlear implants (oCIs) to overcome eCI shortcomings. In this review, we present the current state of the optogenetic sound encoding. We highlight optical sound coding strategy development capitalizing on the optical stimulation that requires fine-grained, fast, and power-efficient real-time sound processing controlling dozens of microscale optical emitters as an emerging research area.
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Affiliation(s)
- Lakshay Khurana
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany
- Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany
- Auditory Neuroscience and Synaptic Nanophysiology Group, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany
- Junior Research Group “Computational Neuroscience and Neuroengineering”, Göttingen, Germany
- The Doctoral Program “Sensory and Motor Neuroscience”, Göttingen Graduate Center for Neurosciences, Biophysics, and Molecular Biosciences (GGNB), Göttingen, Germany
- InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Tamas Harczos
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany
- Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany
| | - Tobias Moser
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany
- Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany
- Auditory Neuroscience and Synaptic Nanophysiology Group, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany
- InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
- Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), University of Göttingen, Göttingen, Germany
| | - Lukasz Jablonski
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany
- Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany
- Junior Research Group “Computational Neuroscience and Neuroengineering”, Göttingen, Germany
- InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
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Alahmadi A, Abdelsamad Y, Alothman NI, Alshalan A, Almuhawas F, AlAmari NA, Alyousef MY, Alhabib SF, Hagr A. A Literature Review on Cochlear Implant Activation: From Weeks to Hours. EAR, NOSE & THROAT JOURNAL 2023:1455613231188294. [PMID: 37551795 DOI: 10.1177/01455613231188294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Objectives: The present literature review discusses the chronological evolution of Cochlear Implant (CI) activation and its definition among the relevant studies in the literature. In addition, the benefits of standardizing the early activation process in implantation centers worldwide are discussed. Methods: A comprehensive literature search was conducted in the major databases such as PubMed, Scopus, and Embase to retrieve all the relevant articles that reported early activation approaches following CI. Results: The evolution of the timing of early activation after CI has been remarkable in the past few years. Some studies reported the feasibility of early activation 1 day after the CI surgery in their users. Conclusions: Within the last decade, some studies have been published to report the feasibility and outcomes of its early activation. However, the process of early activation was not adequately defined, and no apparent guidelines could be found in the literature.
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Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Noura I Alothman
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Afrah Alshalan
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Fida Almuhawas
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nouf A AlAmari
- Otolaryngology-Head & Neck Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Y Alyousef
- Otolaryngology-Head & Neck Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Salman F Alhabib
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Farrell JD, Wang J, MacDougall D, Yang X, Brewer K, Couvreur F, Shoman N, Morris DP, Adamson RBA. Geometrically accurate real-time volumetric visualization of the middle ear using optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:3152-3171. [PMID: 37497518 PMCID: PMC10368046 DOI: 10.1364/boe.488845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 07/28/2023]
Abstract
We introduce a novel system for geometrically accurate, continuous, live, volumetric middle ear optical coherence tomography imaging over a 10.9mm×30∘×30∘ field of view (FOV) from a handheld imaging probe. The system employs a discretized spiral scanning (DC-SC) pattern to rapidly collect volumetric data and applies real-time scan conversion and lateral angular distortion correction to reduce geometric inaccuracies to below the system's lateral resolution over 92% of the FOV. We validate the geometric accuracy of the resulting images through comparison with co-registered micro-computed tomography (micro-CT) volumes of a phantom target and a cadaveric middle ear. The system's real-time volumetric imaging capabilities are assessed by imaging the ear of a healthy subject while performing dynamic pressurization of the middle ear in a Valsalva maneuver.
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Affiliation(s)
- Joshua D. Farrell
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Junzhe Wang
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Dan MacDougall
- Audioptics Medical Incorporated, 1344 Summer St, Halifax NS, B3H 0A8, Canada
| | - Xiaojie Yang
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Kimberly Brewer
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
- Department of Diagnostic Radiology, Microbiology & Immunology, Physics & Atmospheric Science, Dalhousie University, Halifax NS, B3H 4R2, Canada
| | - Floor Couvreur
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
- Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint-Jan’s Hospital, Ruddershove 10, 8000 Bruges, Belgium
| | - Nael Shoman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - David P Morris
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - Robert B. A. Adamson
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
- Electrical and Computer Engineering Department, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Li Z, Zhou L, Tan S, Tang A. Application of UNETR for automatic cochlear segmentation in temporal bone CTs. Auris Nasus Larynx 2023; 50:212-217. [PMID: 35970625 DOI: 10.1016/j.anl.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/02/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the feasibility of a deep learning method based on a UNETR model for fully automatic segmentation of the cochlea in temporal bone CT images. METHODS The normal temporal bone CTs of 77 patients were used in 3D U-Net and UNETR model automatic cochlear segmentation. Tests were performed on two types of CT datasets and cochlear deformity datasets. RESULTS Through training the UNETR model, when batch_size=1, the Dice coefficient of the normal cochlear test set was 0.92, which was higher than that of the 3D U-Net model; on the GE 256 CT, SE-DS CT and Cochlear Deformity CT dataset tests, the Dice coefficients were 0.91, 0.93, 0 93, respectively. CONCLUSION According to the anatomical characteristics of the temporal bone, the use of the UNETR model can achieve fully automatic segmentation of the cochlea and obtain an accuracy close to manual segmentation. This method is feasible and has high accuracy.
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Affiliation(s)
- Zhenhua Li
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, China
| | - Langtao Zhou
- School of Computer Science and Cyber Engineering, Guangzhou University, Guangzhou, China
| | - Songhua Tan
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, China
| | - Anzhou Tang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530000, China.
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Sprinzl GM, Magele A. Personalized Medicine in Otolaryngology: Special Topic Otology. J Pers Med 2022; 12:jpm12111820. [PMID: 36579531 PMCID: PMC9697707 DOI: 10.3390/jpm12111820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Globally, more than 1.5 billion people experience some degree of hearing loss [...].
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Affiliation(s)
- Georg Mathias Sprinzl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, Henri Dunant Platz 1, 3100 St. Pölten, Austria
- Correspondence: ; Tel.: +43-2742-9004-11500
| | - Astrid Magele
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, Henri Dunant Platz 1, 3100 St. Pölten, Austria
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Robotics and cochlear implant surgery: goals and developments. Curr Opin Otolaryngol Head Neck Surg 2022; 30:314-319. [PMID: 36036531 DOI: 10.1097/moo.0000000000000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Cochlear implantation (CI) is a viable option for patients with severe sensorineural hearing loss. Advances in CI have focused on minimizing cochlear trauma to improve hearing preservation outcomes, and in doing so expanding candidacy to patients with useful cochlear reserve. Robotics holds promise as a potential tool to minimize intracochlear trauma with electrode insertion, improve surgical efficiency, and reduce surgical complications. The purpose of this review is to summarize efforts and advances in the field of robotic-assisted CI. RECENT FINDINGS Work on robotics and CI over the past few decades has explored distinct surgical aspects, including image-based surgical planning and intraoperative guidance, minimally invasive robotic-assisted approaches mainly through percutaneous keyhole direct cochlear access, robotic electrode insertion systems, robotic manipulators, and drilling feedback control through end effector sensors. Feasibility and safety have been established and many devices are undergoing clinical trials for clinical adoption, with some having already achieved approval of national licensing bodies. SUMMARY Significant work has been done over the past two decades that has shown robotic-assisted CI to be feasible and safe. Wider clinical adoption can potentially result in improved hearing preservation and quality of life outcomes to more CI candidates.
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Khurana L, Keppeler D, Jablonski L, Moser T. Model-based prediction of optogenetic sound encoding in the human cochlea by future optical cochlear implants. Comput Struct Biotechnol J 2022; 20:3621-3629. [PMID: 35860414 PMCID: PMC9283772 DOI: 10.1016/j.csbj.2022.06.061] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 01/17/2023] Open
Abstract
When hearing fails, electrical cochlear implants (eCIs) partially restore hearing by direct stimulation of spiral ganglion neurons (SGNs). As light can be better confined in space than electrical current, optical CIs (oCIs) provide more spectral information promising a fundamental improvement of hearing restoration by cochlear implants. Here, we turned to computer modelling for predicting the outcome of optogenetic hearing restoration by future oCIs in humans. We combined three-dimensional reconstruction of the human cochlea with ray-tracing simulation of emission from LED or laser-coupled waveguide emitters of the oCI. Irradiance was read out at the somata of SGNs. The irradiance values reached with waveguides were about 14 times higher than with LEDs, at the same radiant flux of the emitter. Moreover, waveguides outperformed LEDs regarding spectral selectivity. oCIs with either emitter type showed greater spectral selectivity when compared to eCI. In addition, modeling the effects of the source-to-SGN distance, orientation of the sources and impact of scar tissue further informs the development of optogenetic hearing restoration.
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Affiliation(s)
- Lakshay Khurana
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany.,Göttingen Graduate Center for Neurosciences, Biophysics, and Molecular Biosciences (GGNB), University of Göttingen, Göttingen, Germany.,InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Daniel Keppeler
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany.,InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Lukasz Jablonski
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany.,InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Moser
- Institute for Auditory Neuroscience, University Medical Center Göttingen, Göttingen, Germany.,Auditory Neuroscience and Optogenetics Laboratory, German Primate Center, Göttingen, Germany.,Auditory Neuroscience & Synaptic Nanophysiology Group, Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany.,InnerEarLab, University Medical Center Göttingen, Göttingen, Germany.,Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, Göttingen, Germany
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Salcher R, John S, Stieghorst J, Kluge M, Repp F, Fröhlich M, Lenarz T. Minimally Invasive Cochlear Implantation: First-in-Man of Patient-Specific Positioning Jigs. Front Neurol 2022; 13:829478. [PMID: 35547379 PMCID: PMC9082655 DOI: 10.3389/fneur.2022.829478] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/16/2022] [Indexed: 11/20/2022] Open
Abstract
A minimally-invasive surgical (MIS) approach to cochlear implantation, if safe, practical, simple in surgical handling, and also affordable has the potential to replace the conventional surgical approaches. Our MIS approach uses patient-specific drilling templates (positioning jigs). While the most popular MIS approaches use robots, the robotic aspect is literally put aside, because our high-precision parallel kinematics is only used to individualize a positioning jig. This jig can then be mounted onto a bone-anchored mini-stereotactic frame at the patient's skull and used to create a drill-hole through the temporal bone to the patient's cochlea. We present the first clinical experience where we use sham drill bits of different diameters instead of drilling into the bone in order to demonstrate the feasibility and accuracy.
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Affiliation(s)
- Rolf Salcher
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
| | | | | | | | | | - Max Fröhlich
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
- MED-EL Research Center, Hannover, Germany
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
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