Robert F Labadie1, Jack H Noble1,2. 1. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center. 2. Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee.
Abstract
HYPOTHESIS: Using patient-customized cochlear measurements obtained from preoperative computed tomography (CT) scans to guide insertion of cochlear implant (CI) electrode arrays will lead to more optimal intracochlear positioning. BACKGROUND: Cochlear duct length is highly variable ranging from 25.26 to 35.46 mm, yet CI electrode arrays are treated as one size fits most. We sought to investigate the impact of patient-customized insertion plans on final location of electrode arrays. METHODS: Twenty cadaveric temporal bone specimens were CT scanned and randomly divided into groups A and B. Group A specimens had an optimal customized insertion plan generated including entry site (e.g., round window versus extended round window), entry vector based on anatomical landmarks (e.g., hug posterior aspect of facial recess and angle 1 mm inferior to stapes), depth to begin advancing off stylet, and final insertion depth. Suboptimal plans were chosen for group B by selecting an approach that was normal yet predicted to result in poor final electrode location. One surgeon, blinded as to group, carried out the CI insertions following which the electrode array was fixed using superglue and the specimen CT scanned to allow assessment of final electrode location. RESULTS: Average perimodiolar distances for groups A and B were 0.51 and 0.60 mm, respectively. For group A, full scala tympani insertion was achieved in all specimens while in group B, 4 of 10 specimens had scalar translocation. CONCLUSION: Patient customized cochlear implant insertion techniques achieved better positioning of electrode arrays in this study and have potential for improving electrode positioning in patients.
HYPOTHESIS: Using patient-customized cochlear measurements obtained from preoperative computed tomography (CT) scans to guide insertion of cochlear implant (CI) electrode arrays will lead to more optimal intracochlear positioning. BACKGROUND: Cochlear duct length is highly variable ranging from 25.26 to 35.46 mm, yet CI electrode arrays are treated as one size fits most. We sought to investigate the impact of patient-customized insertion plans on final location of electrode arrays. METHODS: Twenty cadaveric temporal bone specimens were CT scanned and randomly divided into groups A and B. Group A specimens had an optimal customized insertion plan generated including entry site (e.g., round window versus extended round window), entry vector based on anatomical landmarks (e.g., hug posterior aspect of facial recess and angle 1 mm inferior to stapes), depth to begin advancing off stylet, and final insertion depth. Suboptimal plans were chosen for group B by selecting an approach that was normal yet predicted to result in poor final electrode location. One surgeon, blinded as to group, carried out the CI insertions following which the electrode array was fixed using superglue and the specimen CT scanned to allow assessment of final electrode location. RESULTS: Average perimodiolar distances for groups A and B were 0.51 and 0.60 mm, respectively. For group A, full scala tympani insertion was achieved in all specimens while in group B, 4 of 10 specimens had scalar translocation. CONCLUSION:Patient customized cochlear implant insertion techniques achieved better positioning of electrode arrays in this study and have potential for improving electrode positioning in patients.
Authors: George B Wanna; Jack H Noble; Rene H Gifford; Mary S Dietrich; Alex D Sweeney; Dongqing Zhang; Benoit M Dawant; Alejandro Rivas; Robert F Labadie Journal: Otol Neurotol Date: 2015-09 Impact factor: 2.311
Authors: Jack H Noble; Andrea J Hedley-Williams; Linsey Sunderhaus; Benoit M Dawant; Robert F Labadie; Stephen M Camarata; René H Gifford Journal: Otol Neurotol Date: 2016-02 Impact factor: 2.311
Authors: Jack H Noble; René H Gifford; Andrea J Hedley-Williams; Benoit M Dawant; Robert F Labadie Journal: Audiol Neurootol Date: 2014-11-07 Impact factor: 1.854
Authors: Matthew L Carlson; Colin L W Driscoll; René H Gifford; Geoffrey J Service; Nicole M Tombers; Becky J Hughes-Borst; Brian A Neff; Charles W Beatty Journal: Otol Neurotol Date: 2011-08 Impact factor: 2.311
Authors: Jack H Noble; Robert F Labadie; René H Gifford; Benoit M Dawant Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2013-03-19 Impact factor: 3.802
Authors: Laura K Holden; Charles C Finley; Jill B Firszt; Timothy A Holden; Christine Brenner; Lisa G Potts; Brenda D Gotter; Sallie S Vanderhoof; Karen Mispagel; Gitry Heydebrand; Margaret W Skinner Journal: Ear Hear Date: 2013 May-Jun Impact factor: 3.570
Authors: William G Morrel; Katherine E Riojas; Robert J Webster; Jack H Noble; Robert F Labadie Journal: Int J Comput Assist Radiol Surg Date: 2020-05-14 Impact factor: 2.924
Authors: Srijata Chakravorti; Jack H Noble; René H Gifford; Benoit M Dawant; Brendan P O'Connell; Jianing Wang; Robert F Labadie Journal: Otol Neurotol Date: 2019-06 Impact factor: 2.311
Authors: Yubo Fan; Rueben A Banalagay; Nathan D Cass; Jack H Noble; Kareem O Tawfik; Robert F Labadie; Benoit M Dawant Journal: Annu Int Conf IEEE Eng Med Biol Soc Date: 2021-11
Authors: José Santos Cruz de Andrade; Peter Baumhoff; Oswaldo Laércio Mendonça Cruz; Thomas Lenarz; Andrej Kral Journal: Braz J Otorhinolaryngol Date: 2020-09-20