Intraoperative use of cone-beam computed tomography in a cadaveric ossified cochlea model.
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.
Barker
Emma
E
Departments of Otolaryngology-Head and Neck Surgery and Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. emma.barker@uhn.on.ca
Trimble
Keith
K
Chan
Harley
H
Ramsden
James
J
Nithiananthan
Sajendra
S
James
Adrian
A
Bachar
Gideon
G
Daly
Mike
M
Irish
Jonathan
J
Siewerdsen
Jeff
J
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*