{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:35:48Z","timestamp":1789421748728,"version":"build-2803163510"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020045","name":"Oticon Medical","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100020045","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Hypothesis<\/jats:title>\n<jats:p>To develop and validate the optimal design and evaluate accuracy of individualized 3D- printed surgical guides for cochlear implantation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Background<\/jats:title>\n<jats:p>Positioning and fixation of the cochlear implant (CI) are commonly performed free hand. Applications of 3-dimensional (3D) technology now allow us to make patient specific, bone supported surgical guides, to aid CI surgeons with precise placement and drilling out the bony well which accommodates the receiver\/stimulator device of the CI.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Cone beam CT (CBCT) scans were acquired from temporal bones in 9 cadaveric heads (18 ears), followed by virtual planning of the CI position. Surgical, bone-supported drilling guides were designed to conduct a minimally invasive procedure and were 3D-printed. Fixation screws were used to keep the guide in place in predetermined bone areas. Specimens were implanted with 3 different CI models. After implantation, CBCT scans of the implanted specimens were performed. Accuracy of CI placement was assessed by comparing the 3D models of the planned and implanted CI\u2019s by calculating the translational and rotational deviations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Median translational deviations of placement in the X- and Y-axis were within the predetermined clinically relevant deviation range (&lt; 3 mm per axis); median translational deviation in the Z-axis was 3.41 mm. Median rotational deviations of placement for X-, Y- and Z-rotation were 5.50\u00b0, 4.58\u00b0 and 3.71\u00b0, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study resulted in the first 3D-printed, patient- and CI- model specific surgical guide for positioning during cochlear implantation. The next step for the development and evaluation of this surgical guide will be to evaluate the method in clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270517","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T17:27:32Z","timestamp":1658770052000},"page":"e0270517","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cochlear implant positioning and fixation using 3D-printed patient specific surgical guides; a cadaveric study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9913-9656","authenticated-orcid":true,"given":"Laura M.","family":"Markodimitraki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7394-2953","authenticated-orcid":true,"given":"Timen C.","family":"ten Harkel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L. 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A systematic review","volume":"129","author":"CJ Hong","year":"2019","journal-title":"Laryngoscope"},{"issue":"2","key":"pone.0270517.ref011","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1001\/jamaoto.2016.3002","article-title":"Advances in 3-dimensional printing in otolaryngology a review","volume":"143","author":"KK VanKoevering","year":"2017","journal-title":"JAMA Otolaryngol\u2014Head Neck Surg"},{"issue":"12","key":"pone.0270517.ref012","doi-asserted-by":"crossref","first-page":"3669","DOI":"10.1007\/s00405-014-3452-1","article-title":"Template-guided implantation of the Bonebridge: clinical experience","volume":"272","author":"N Matsumoto","year":"2014","journal-title":"Eur Arch Oto-Rhino-Laryngology"},{"issue":"11","key":"pone.0270517.ref013","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1007\/s11548-016-1441-0","article-title":"Registration using 3D-printed rigid templates outperforms manually scanned surface matching in image-guided temporal bone 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