Electrical Impedance to Assess Facial Nerve Proximity during Robotic Cochlear Implantation

Anso, Juan; Wyss, Thomas; Jegge, Yves; Kalvoy, Havard; Bell, Brett; Dür, Cilgia; Calvo, Enric M.; Williamson, Tom; Gerber, Nicolas; Ferrario, Damien; Forterre, Franck; Büchler, Philippe; Stahel, Andreas; Caversaccio, Marco; Weber, Stefan; Gerber, Kate (2018). Electrical Impedance to Assess Facial Nerve Proximity during Robotic Cochlear Implantation. IEEE transactions on biomedical engineering, 66(1), pp. 237-245. Institute of Electrical and Electronics Engineers IEEE 10.1109/TBME.2018.2830303

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Reported studies pertaining to needle guidance suggest that tissue impedance available from neuromonitoring systems can be used to discriminate nerve tissue proximity. In this pilot study, the existence of a relationship between intraoperative electrical impedance and tissue density, estimated from computer tomography (CT) images, is evaluated in the mastoid bone of in- vivo sheep. In five subjects, nine trajectories were drilled using an image-guided surgical robot. Per trajectory, five measurement points near the facial nerve were accessed and electrical impedance was measured (≤ 1 KHz) using a multipolar electrode probe. Micro-CT was used postoperatively to measure the distances from the drilled trajectories to the facial nerve. Tissue density was determined from co-registered preoperative CT images and, following sensitivity field modelling of the measuring tip, tissue resistivity was calculated. The relationship between impedance and density was determined for 29 trajectories passing or intersecting the facial nerve. A monotonic decrease in impedance magnitude was observed in all trajectories with a drill axis intersecting the facial nerve. Mean tissue densities intersecting with the facial nerve (971-1161 HU) were different (p < 0.01) from those along safe trajectories passing the nerve (1194-1449 HU). However, mean resistivity values of trajectories intersecting the facial nerve (14-24 Ωm) were similar to those of safe passing trajectories (17-23 Ωm). The determined relationship between tissue density and electrical impedance during neuromonitoring of the facial nerve suggests that impedance spectroscopy may be used to increase the accuracy of tissue discrimination, and ultimately improve nerve safety distance assessment in the future.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV)
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy > ARTORG Center - Artificial Hearing Research

UniBE Contributor:

Anso, Juan; Wyss, Thomas; Jegge, Yves; Bell, Brett; Dür, Cilgia; Williamson, Tom; Gerber, Nicolas; Forterre, Franck; Büchler, Philippe; Stahel, Andreas; Caversaccio, Marco; Weber, Stefan and Gerber, Kate

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0018-9294

Publisher:

Institute of Electrical and Electronics Engineers IEEE

Language:

English

Submitter:

Juan Anso

Date Deposited:

04 Jun 2018 15:50

Last Modified:

13 Jan 2019 19:23

Publisher DOI:

10.1109/TBME.2018.2830303

PubMed ID:

29993441

BORIS DOI:

10.7892/boris.116962

URI:

https://boris.unibe.ch/id/eprint/116962

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