Image-guided implantation of the Bonebridge™ with a surgical navigation: A feasibility study

OBJECTIVE: To access a method of fitting a designated location on the patient’s temporal bone by surgically navigating to the Bonebridge implantation. STUDY DESIGN: A patient with unilateral profound hearing loss received early intervention with the Bonebridge implant for binaural hearing. The optimal implant site was determined from computed tomography (CT) images using a three-dimensional (3D) simulation software program before the surgery. The pre-calculated coordinates from the 3D simulation software program were moved to the Scopis Hybrid Navigation System. After using the surgical navigation system for the surgery, we evaluated the degree of mismatch of the center of the bone conduction-floating mass transducer (BC-FMT) between the computer simulation and the actual drilling. RESULTS: The time required to determine the implant location on the surface of the patient’s temporal bone was shortened, and the accuracy of the implantation was high. The coordinates on the 3D simulation system were comparable to the surgical navigation system. The predicted coordinates were replicated exactly upon actual drilling during the surgery, and we could confirm this in preoperative and postoperative images. CONCLUSIONS: Using an image-guided surgical navigation system to aid in the placement of the BC-FMT on the simulated location is a simple procedure and is more effective that finding the exact coordinates. It also shortens the decision time for applying the implant.