Endoscopic vs. volumetric OCT imaging of mastoid bone structure for pose estimation in minimally invasive cochlear implant surgery
Purpose: The facial recess is a delicate structure that must be protected in minimally invasive cochlear implant surgery. Current research estimates the drill trajectory by using endoscopy of the unique mastoid patterns. However, missing depth information limits available features for a registration to preoperative CT data. Therefore, this paper evaluates OCT for enhanced imaging of drill holes in mastoid bone and compares OCT data to original endoscopic images. 
Methods: A catheter-based OCT probe is inserted into a drill trajectory of a mastoid phantom in a translation-rotation manner to acquire the inner surface state. The images are undistorted and stitched to create volumentric data of the drill hole. The mastoid cell pattern is segmented automatically and compared to ground truth. 
Results: The mastoid pattern segmented on images acquired with OCT show a similarity of J = 73.6 % to ground truth based on endoscopic images and measured with the Jaccard metric. Leveraged by additional depth information, automated segmentation tends to be more robust and fail-safe compared to endoscopic images. 
Conclusion: The feasibility of using a clinically approved OCT probe for imaging the drill hole in cochlear implantation is shown. The resulting volumentric images provide additional information on the shape of caveties in the bone structure, which will be useful for image-to-patient registration and to estimate the drill trajectory. This will be another step towards safe minimally invasive cochlear implantation.