Cochlear implant surgery typically requires a wide-field mastoidectomy to access the cochlea. This portion of thesurgery can leave a visible and palpable depression behind the patient's ear, which can be cosmetically displeasingto the patient. For the surgeon, a wide-field mastoidectomy is challenging to perform because bone must begradually removed by freehand drilling guided primarily by visual feedback in an effort to detect, yet avoid,vital anatomy including the facial nerve which controls motion of the face. Toward overcoming these issues andstandardizing surgery, imaged-guided, minimally invasive approaches have been developed in which the cochleais accessed using a single pre-planned drill trajectory. This approach promises decreased invasiveness, but thelimited surgical view and long narrow opening to the cochlea present significant challenges for inserting electrodearrays. This paper describes the first cadaver experiments using a new manual insertion tool which provides aroller mechanism to enable the physician to deploy a cochlear implant electrode array through the narrow drilledhole created by this minimally invasive, image-guided access technique. Results demonstrate that the new toolenables consistent and successful insertions similar to insertions with the traditional tool while increasing theease of the insertion and freeing the surgeon to monitor progress and make fine adjustments as needed.
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