title: A practical, single-view alternative to Stenver's for plain radiographic unilateral and bilateral post-cochlear implant position check.
abstract: BACKGROUND
  'Stenver's' is the standard plain radiograph view to check the electrode position after cochlear implantation. However, a reproducible alignment for intra-individual comparison of electrode position using a true Stenver's alignment is not always straightforward to achieve, particularly for inexperienced radiographers, or on non-compliant children. In addition, two ionizing exposures in two different positions are required for bilateral cochlear implants.
  
  
  OBJECTIVE
  To assess the efficacy of other, more simple, single-exposure radiographs for the assessment of electrode position.
  
  
  METHODS
  Dummy electrodes and receiver units were bilaterally implanted into a cadaver. Plain radiographs in Stenver's views, and plain antero-posterior (AP) midline radiographic single views incorporating both implants were obtained with the tube at a range of angles tilted caudal and cranial to the perpendicular. Five internationally renowned cochlear implant surgeons were each asked if each radiograph gave adequate information for unilateral and for bilateral implants and they were asked to list in order of their favoured top three views.
  
  
  RESULTS
  No surgeon thought that a single-exposure Stenver's view was adequate for assessment of the contra-lateral side. Consensus was that all AP views were fit for the purpose, with no preference given between each of the AP views. The ipsi-lateral Stenver's was considered to give better depth of insertion information.
  
  
  CONCLUSIONS
  There is no apparent advantage of caudal and cranial tilt angles over a straight perpendicular AP. A single-view AP radiograph is an alternative to Stenver's view for a post-unilateral and post-simultaneous bilateral cochlear implant check.
authors.affiliation: Department of Otolaryngology, St George's Hospital, London, UK. bertieharris@yahoo.com
authors.forename: Robert
authors.initials: R
authors.lastname: Harris
authors.forename: Chris
authors.initials: C
authors.lastname: Pepper
authors.forename: Lee
authors.initials: L
authors.lastname: Dennis
authors.forename: Phillip
authors.initials: P
authors.lastname: Rich
authors.forename: David
authors.initials: D
authors.lastname: Selvadurai
mesh_terms: D002102:Cadaver; D003051:Cochlea / Q000000981:diagnostic imaging*; D019929:Cochlear Implantation / Q000009:adverse effects / Q000379:methods; D003054:Cochlear Implants; D004567:Electrodes, Implanted; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D011475:Prosthesis Failure; D011859:Radiography