COMPUTER-SIMULATED TEST FITTING OF AN IMPLANTABLE HEARING-AID USING 3-DIMENSIONAL CT SCANS OF THE TEMPORAL BONE - PRELIMINARY-STUDY

In preparation for future implantation of the implantable middle ear t ransducer in patients, a method was sought for preoperatively test fit ting a model of the device, using computer generated three-dimensional (3-D) temporal bone images derived from spiral computed tomography (C T) data. A 3-D model of the implantable middle ear transducer was desi gned using NIH Image software on a Macintosh computer. High resolution human temporal bone CT scans were obtained using a spiral CT scanner (Siemens Somatom Plus S). The 3-D transducer model was superimposed on to 3-D reconstructions of the temporal bone using ANALYZE software on a computer graphics workstation (Sun SPARCstation 10), showing the tra nsducer ''implanted'' in the temporal bone. Measurements were validate d using a cadaver temporal bone. This process produced images demonstr ating the ''fit'' of the current transducer design in the mastoid regi on of the adult temporal bone. It permitted assessment of the proximit y of surrounding structures such as the external auditory meatus, dura , or sigmoid sinus. Preliminary cadaver validation measurements confir med the accuracy of this method. Three-dimensional CT is a feasible me thod for preoperative planning of the surgical implantation of devices in the temporal bone. This method of 3-D test fitting will be used in the future to determine optimum orientation and size limitations for human implantable devices.