Introduction of the xCAT: Xoran's most powerful CT Scanner to date, offering sub-millimeter resolution for superior geometrical accuracy. The xCAT radiation dose is a small fraction of conventional head CT, while the entire scanner is compact and portable using a 4 wheels design.

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• Agile - xCAT™ is easily
positioned for intraoperative
CT3
• Compact- Fits in a compact
OR, small footprint with
steering that pivots on a dime
• Practical - A 4-wheeled
solution that travels and
stores well within the clinic
• Real-time - Update image
guidance to quickly improve
accuracy intraoperatively,5,10
• Exact – confirm implant
position and surgical
completeness7
• Image quality - Superior
geometrical accuracy with
sub-millimeter resolution8,9
• Confidence – shown to alter
surgical decision making1,2,10
• Safety – Radiation dose is a
small fraction of conventional
head CT
• Quality - Aligns with the
Institute of Medicine’s High
Quality Care 11

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ENT & Skull Base
Cochlear Implants
CMF & Trauma

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Sinus and Skull Base Cochlear Implants CMF and Trauma
• Visualize stent position
• Dissection of ethmoid partitions
• Visualize the need for additional
resection
• Detect residual bony fragments
• Imaging shown to alter surgical
desicions1,2
• Sub-millimeter resolution with
geometric accuracy6,8
• Visualize placement of
electrodes6
• Visualization of intra-cochlear
trauma and Intra-scalar
positioning5
• Imaging to support minimally-
invasive and robotic procedures7
• Imaging supports fracture
reduction
• Visualize implant placement
• Detect residual bony fragments
• Imaging shown to alter surgical
plan4
Cochlear
Vanderbilt University Medical Center
Nashville, TN
ENT
Kopf Klinic Frankfurt GmbH
Germany
ENT
Copenhagen University
Denmark
ENT/CMF
University Hospital of Mannheim
Germany
CMF
Zurich
Switzerland
xCAT Locations with key publications:
Cochlear
Hannover
Germany
Cochlear
University of Bern
Switzerland
CMF
Dresden
Germany
ENT/Cochlear
Ulm
Germany
ENT/CMF/Cochlear
Dusseldorf
Germany

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FESS
• Scan and IGS ready within minutes9
• Alters surgical plan1,2
Use of intraoperative CT scanning in endoscopic sinus surgery: a preliminary report.
Jackman AH1, Palmer JN, Chiu AG, Kennedy DW. Am J Rhinol. 2008 Mar-Apr;22(2):170-4.
doi: 10.2500/ajr.2008.22.3153.

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Cochlear Implantation
• Confirmation of electrode position5

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Evaluation of portable CT scanners for otological image-guided surgery. Balachandran et al. 2012. Int J Comput
Assist Radiol Surg 7(2); Design of a bone-attached parallel robot for percutaneous cochlear implantation.
Kratchman et al. L.B. 2011. IEEE 58(10):
Cochlear Implantation
• Minimally invasive technique5

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xCAT for Facial Fractures

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Facial Fractures
• Intraoperative confirmation of mesh placement*
*Brainlab using xCAT images

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C-Arm Facial Fractures Images
• Alternative – 3D C-arm

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xCAT ENT
• Intraoperative use

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Select Publications
1. Use of intraoperative CT scanning in endoscopic sinus surgery: a preliminary report. Jackman A, Palmer JN, Chiu AG,
Kennedy DW, Am J Rhinol. (2008)
2.
2. Clinical utility of intraoperative volume computed tomography scanner for endoscopic sinonasal and skull base procedures.
Batra PS1, Kanowitz SJ, Citardi MJ. Am J Rhinol. (2008)
3. Comparison of Intraoperative Portable CT Scanners in Skull Base and Endoscopic Sinus Surgery: Single Center Case
Series. David B. Conley et.al. Skull Base. (2011)
4. Intraoperative cone beam computed tomography in the management of facial fractures. Stuck, B. A., R. Hülse, and T. J.
Barth. International journal of oral and maxillofacial surgery (2012)
5. Evaluation of portable CT scanners for otologic image-guided surgery. Balachandran et al. Int J Comput Assist RadiolSurg
(2012)
6. Automatic pre- to intra-operative CT registration for image-guided cochlear implant surgery Fitsum A. Reda, Jack H. Noble,
Robert F. Labadie, and Benoit M. Dawant, IEEE Trans Biomed Eng. (2012)
7.
7. Minimally invasive image-guided cochlear implantation surgery: first report of clinical implementation. Labadie RF1,
Balachandran R, Noble JH, Blachon GS, Mitchell JE, Reda FA, Dawant BM, Fitzpatrick JM, Laryngoscope (2014)
8. Flat-panel CT vs multislice CT to evaluate cochlear implant positioning. Zeitler DM et al. Cochlear implants International
(2011)
9. The use of portable intraoperative CT for real-time image guidance: a pilot study. Das et. al. American Journal or Rhinology
(2008)
10. Intraoperative IGS/CT updates for complex endoscopic frontal sinus surgery. Chennupati SK1, Woodworth BA, Palmer
JN, Cohen NA, Kennedy DW, Chiu AG. (2008)
11. AAO-HNS Position Statement on Point of Care Imaging in Otolaryngology. http://www.entnet.org (2017)