title: High-resolution cone-beam computed tomography: a potential tool to improve atraumatic electrode design and position.
abstract: CONCLUSIONS
  Flat-panel cone-beam computed tomography (CBCT) is able to assess the trajectory of the implanted cochlear implant (CI) array. This is essential to determine specific effects of electrode design and surgical innovations on outcomes in cochlear implantation. CBCT is a non-invasive approach yielding similar data to histopathological analyses, with encouraging potential for use in surgical, clinical and research settings.
  
  
  OBJECTIVE
  To examine the fidelity of CBCT imaging and custom 3D visualization in characterizing CI insertion in comparison to gold standard, histopathological examination.
  
  
  METHODS
  Eleven human temporal bones were implanted with the 'Straight Research Array' (SRA). Post-insertion, they were imaged with a prototype mobile C-arm for intraoperative CBCT. Post-acquisition processing of low-dose CBCT images produced high-resolution 3D volumes with sub-millimetre spatial resolution (isotropic 0.2 mm(3) voxels). The bones were resin impregnated and sectioned for light microscopic examination. Dimensional electrode characteristics visible in section images were compared with corresponding CBCT images by independent observers.
  
  
  RESULTS
  Overall, CBCT demonstrated adequate resolution to detect: 1) scala implanted; 2) kinking; 3) number of intracochlear contacts; 4) appropriate ascension of the array; and overall confirms ideal insertion. CBCT did not demonstrate adequate resolution to detect reversal of electrode contacts or basilar membrane rupture.
authors.affiliation: Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, ON, Canada. sharon.cushing@sickkids.ca
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Cushing
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Daly
authors.forename: Claudiu G
authors.initials: CG
authors.lastname: Treaba
authors.forename: Harley
authors.initials: H
authors.lastname: Chan
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
authors.forename: Susan
authors.initials: S
authors.lastname: Blaser
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gordon
authors.forename: Blake C
authors.initials: BC
authors.lastname: Papsin
mesh_terms: D019929:Cochlear Implantation; D054893:Cone-Beam Computed Tomography; D006801:Humans; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery*