title: Intraoperative use of cone-beam computed tomography in a cadaveric ossified cochlea model.
abstract: OBJECTIVE
  To describe a cadaveric temporal bone model of labyrinthitis ossificans and investigate the utility of intraoperative cone-beam computed tomography (CBCT) in the facilitating cochlear implantation.
  
  
  METHODS
  Cadaveric temporal bone study.
  
  
  METHODS
  Five cadaveric heads had cement introduced into the 10 cochleas. CBCT and a conventional CT scan were compared to assess the extent of cochlear obliteration. The cement was drilled-out (under CBCT guidance, if required) and cochlear implant electrode arrays (from 3 different manufacturers) inserted.
  
  
  RESULTS
  CBCT images demonstrated temporal bone anatomy and the extent of cochlear obliteration as clearly as conventional CT in all cases. Intraoperative CBCT guided drilling and facilitated electrode placement in two of five heads (3 of 10 ears). Streak-artifact from the electrodes of two devices partially obscured image clarity.
  
  
  CONCLUSIONS
  The obliterated cochlear model reproduced a disease-ossified cochlear both radiographically and surgically. CBCT is useful for intraoperative imaging to facilitate electrode array placement in the obliterated or congenitally abnormal cochlea.
authors.affiliation: Departments of Otolaryngology-Head and Neck Surgery and Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. emma.barker@uhn.on.ca
authors.forename: Emma
authors.initials: E
authors.lastname: Barker
authors.forename: Keith
authors.initials: K
authors.lastname: Trimble
authors.forename: Harley
authors.initials: H
authors.lastname: Chan
authors.forename: James
authors.initials: J
authors.lastname: Ramsden
authors.forename: Sajendra
authors.initials: S
authors.lastname: Nithiananthan
authors.forename: Adrian
authors.initials: A
authors.lastname: James
authors.forename: Gideon
authors.initials: G
authors.lastname: Bachar
authors.forename: Mike
authors.initials: M
authors.lastname: Daly
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
authors.forename: Jeff
authors.initials: J
authors.lastname: Siewerdsen
mesh_terms: D002102:Cadaver; D003051:Cochlea / Q000000981:diagnostic imaging*; D003054:Cochlear Implants; D004867:Equipment Design; D006801:Humans; D008953:Models, Anatomic; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging*; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*