CT-assisted navigation for retrosigmoidal implantation of the Bonebridge

The Bonebridge is an active bone conduction implant (BCI) that is primarily indicated in patients with conductive and combined hearing loss. However, many of these patients present with a radical cavity as a result of previous surgery. In these cases, the implant should not be introduced into the mastoid region, but rather via a retrosigmoid approach to maintain separation from the pathological alteration. To ensure the best possible acoustic transduction, the Bone Conduction-Floating Mass Transducer (BC-FMT) should be positioned near to the cochlea. This requires precise identification of the sigmoid sinus, which cannot be achieved accurately enough using external anatomical landmarks. We thus report on two patients in whom the Bonebridge was implanted via a retrosigmoid approach using CT-guided navigation.