Background: Imaging of cochlear implant (CI) electrode arrays (EAs) consists of intraoperative fluoroscopy to rule out tip fold-over and/or post-operative computerized tomography (CT) if concern exists regarding extrusion or misplacement of the EA. Intraoperative CT (iCT) can satisfy these current needs and enables specification of final intracochlear position.Aims/objectives: To describe iCT scanning of CI recipients at an academic medical center.Materials and methods: iCT was used to scan CI recipients within the operating room before recovering from general anesthesia. Results: In fiscal year 2019, 301 CI were placed (83 children, 218 adult). One hundred, seventy-five iCTs were performed (58% of total CIs) of which 52 were children (63% of pediatric CIs) and 123 were adult (57% of adult CIs). Of 7 CI surgeons, use of iCT ranged from 14% to 100% (mean 60%). Four tip fold-overs were identified and corrected intraoperatively. Surgeons reported using the images to improve technique (i.e. pulling back precurved EAs to improve perimodiolar positioning).Conclusion and significance: The current standard of care for CI is to insert EAs without feedback as to final location. iCT provides surgeons with rapid post-insertion feedback which allows detection and correction of suboptimally placed EAs as well as refinement of surgical technique.
Background: Imaging of cochlear implant (CI) electrode arrays (EAs) consists of intraoperative fluoroscopy to rule out tip fold-over and/or post-operative computerized tomography (CT) if concern exists regarding extrusion or misplacement of the EA. Intraoperative CT (iCT) can satisfy these current needs and enables specification of final intracochlear position.Aims/objectives: To describe iCT scanning of CI recipients at an academic medical center.Materials and methods: iCT was used to scan CI recipients within the operating room before recovering from general anesthesia. Results: In fiscal year 2019, 301 CI were placed (83 children, 218 adult). One hundred, seventy-five iCTs were performed (58% of total CIs) of which 52 were children (63% of pediatric CIs) and 123 were adult (57% of adult CIs). Of 7 CI surgeons, use of iCT ranged from 14% to 100% (mean 60%). Four tip fold-overs were identified and corrected intraoperatively. Surgeons reported using the images to improve technique (i.e. pulling back precurved EAs to improve perimodiolar positioning).Conclusion and significance: The current standard of care for CI is to insert EAs without feedback as to final location. iCT provides surgeons with rapid post-insertion feedback which allows detection and correction of suboptimally placed EAs as well as refinement of surgical technique.
Entities:
Keywords:
Cochlear implantation; computerized tomography; intraoperative imaging; quality control
Authors: William G Morrel; Jourdan T Holder; Benoit M Dawant; Jack H Noble; Robert F Labadie Journal: Otolaryngol Head Neck Surg Date: 2020-02-25 Impact factor: 3.497
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