H Jia1,2,3,4, R Torres1, Y Nguyen1,2, D De Seta1,2, E Ferrary1,2, H Wu3, O Sterkers1,2, D Bernardeschi1,2, I Mosnier5,2. 1. From the Unité de Réhabilitation Chirurgicale Mini-Invasive Robotisée de l'Audition (H.J., R.T., Y.N., D.D.S., E.F., O.S., D.B., I.M.), Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Institut National de la Santé et de la Recherche Médicale, Paris, France. 2. Otologie, Implants Auditifs et Chirurgie de la Base du Crane (H.J., Y.N., D.D.S., E.F., O.S., D.B., I.M.), Paris Assistance Publique, GHU Pitié-Salpêtrière, Service ORL, Paris, France. 3. Department of Otolaryngology-Head and Neck Surgery (H.J., H.W.), Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. 4. Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases (H.J.), Jiaotong University School of Medicine, Shanghai, China. 5. From the Unité de Réhabilitation Chirurgicale Mini-Invasive Robotisée de l'Audition (H.J., R.T., Y.N., D.D.S., E.F., O.S., D.B., I.M.), Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Institut National de la Santé et de la Recherche Médicale, Paris, France isabelle.mosnier@aphp.fr.
Abstract
BACKGROUND AND PURPOSE: Intraoperative conebeam CT has been introduced into the operating room and provides quick radiologic feedback. This study aimed to investigate its utility in the assessment of the positioning of the electrode array after cochlear implantation. MATERIALS AND METHODS: This was a retrospective study of 51 patients (65 ears) with intraoperative imaging by conebeam CT (O-arm) after cochlear implantation between 2013 and 2017. Correct placement into the cochlea was immediately identified. Positioning assessments were later analyzed with OsiriX software. RESULTS: Intraoperative imaging was quickly performed in all cases. No misplacement into the vestibule or semicircular canals was found. A foldover of the implanted array was identified in 1 patient. Secondary analysis by 2 raters showed excellent agreement on insertion depth angle (intraclass correlation = 0.96, P < .001) and length of insertion of the electrode array (intraclass correlation coefficient = 0.93, P = .04) measurements. The evaluation of the number of extracochlear electrodes was identical between the 2 raters in 78% of cases (Cohen κ = 0.55, P < .001). The scalar position was inconsistent between raters. When we compared O-arm and high-resolution CT images in 14 cases, the agreement was excellent for insertion depth angle (intraclass correlation coefficient = 0.97, P < .001) and insertion length (intraclass correlation coefficient = 0.98, P < .001), good for the number of extracochlear electrodes (Cohen κ = 0.63, P = .01), but moderate for the scalar position (Cohen κ = 0.59, P = .02). CONCLUSIONS: Intraoperative conebeam CT using the O-arm is a safe, rapid, easy, and reliable procedure to immediately identify a misplacement or foldover of an electrode array. The insertion depth angle, insertion length, and number of electrodes inserted can be accurately assessed.
BACKGROUND AND PURPOSE: Intraoperative conebeam CT has been introduced into the operating room and provides quick radiologic feedback. This study aimed to investigate its utility in the assessment of the positioning of the electrode array after cochlear implantation. MATERIALS AND METHODS: This was a retrospective study of 51 patients (65 ears) with intraoperative imaging by conebeam CT (O-arm) after cochlear implantation between 2013 and 2017. Correct placement into the cochlea was immediately identified. Positioning assessments were later analyzed with OsiriX software. RESULTS: Intraoperative imaging was quickly performed in all cases. No misplacement into the vestibule or semicircular canals was found. A foldover of the implanted array was identified in 1 patient. Secondary analysis by 2 raters showed excellent agreement on insertion depth angle (intraclass correlation = 0.96, P < .001) and length of insertion of the electrode array (intraclass correlation coefficient = 0.93, P = .04) measurements. The evaluation of the number of extracochlear electrodes was identical between the 2 raters in 78% of cases (Cohen κ = 0.55, P < .001). The scalar position was inconsistent between raters. When we compared O-arm and high-resolution CT images in 14 cases, the agreement was excellent for insertion depth angle (intraclass correlation coefficient = 0.97, P < .001) and insertion length (intraclass correlation coefficient = 0.98, P < .001), good for the number of extracochlear electrodes (Cohen κ = 0.63, P = .01), but moderate for the scalar position (Cohen κ = 0.59, P = .02). CONCLUSIONS: Intraoperative conebeam CT using the O-arm is a safe, rapid, easy, and reliable procedure to immediately identify a misplacement or foldover of an electrode array. The insertion depth angle, insertion length, and number of electrodes inserted can be accurately assessed.
Authors: R A Helal; R Jacob; M A Elshinnawy; A I Othman; I M Al-Dhamari; D W Paulus; T T Abdelaziz Journal: AJNR Am J Neuroradiol Date: 2021-01-07 Impact factor: 3.825
Authors: Paul Van de Heyning; Peter Roland; Luis Lassaletta; Sumit Agrawal; Marcus Atlas; Wolf-Dieter Baumgartner; Kevin Brown; Marco Caversaccio; Stefan Dazert; Wolfgang Gstoettner; Rudolf Hagen; Abdulrahman Hagr; Greg Eigner Jablonski; Mohan Kameswaran; Vladislav Kuzovkov; Martin Leinung; Yongxin Li; Andreas Loth; Astrid Magele; Robert Mlynski; Joachim Mueller; Lorne Parnes; Andreas Radeloff; Chris Raine; Gunesh Rajan; Joachim Schmutzhard; Henryk Skarzynski; Piotr H Skarzynski; Georg Sprinzl; Hinrich Staecker; Timo Stöver; Dayse Tavora-Viera; Vedat Topsakal; Shin-Ichi Usami; Vincent Van Rompaey; Nora M Weiss; Wilhelm Wimmer; Mario Zernotti; Javier Gavilan Journal: Front Surg Date: 2022-03-24