Virtual cochlear implantation for personalized rehabilitation of profound hearing loss.

In cochlear implantation, current preoperative planning procedures allow for estimating how far a specific implant will reach into the inner ear of the patient, which is important to optimize hearing preservation and speech perception outcomes. Here we report on the development of a methodology that goes beyond current planning approaches: the proposed model does not only estimate specific outcome parameters but allows for entire, three-dimensional virtual implantations of patient-specific cochlear anatomies with different types of electrode arrays. The model was trained based on imaging datasets of 186 human cochleae, which contained 171 clinical computer tomographies (CTs) of actual cochlear implant patients as well as 15 high-resolution micro-CTs of cadaver cochleae to also reconstruct the refined intracochlear structures not visible in clinical imaging. The model was validated on an independent dataset of 141 preoperative and postoperative clinical CTs of cochlear implant recipients and outperformed all currently available planning approaches, not only in terms of accuracy but also regarding the amount of information that is available prior to the actual implantation.