title: Reliability of cone beam computed tomography in scalar localization of the electrode array: a radio histological study.
abstract: Postoperative imaging plays a growing role in clinical studies concerning prognostic factors in cochlear implantation. Indeed, intracochlear position of the cochlear implant has recently been identified as a contributor in functional outcomes and radiological tools must be accurate enough to determine the final placement of the electrode array. The aim of our study was to validate cone beam computed tomography as a reliable technique for scalar localization of the electrode array. We performed therefore a temporal bone study on ten specimens that were implanted with a perimodiolar implant prototype. Cone beam reconstructions were performed and images were analyzed by two physicians both experienced in cochlear implant imaging, who determined the scalar localization of the implant. Temporal bones then underwent histological control to document this scalar localization and hypothetical intracochlear lesions. In four cases, a dislocation from scala tympani to scala vestibuli was suspected on cone beam reconstructions of the ascending part of the basal turn. In three of these four specimens, dislocation in pars ascendens was confirmed histologically. In the remaining temporal bone, histological analysis revealed an elevation with rupture of the basilar membrane. Histological assessment revealed spiral ligament tearing in another bone. We conclude that cone beam is a reliable tool to assess scalar localization of the selectrode array and may be used in future clinical studies.
authors.affiliation: Department of Otology-Neurotology and Skull Base Surgery, Purpan University Hospital, Place du Docteur Baylac, 31059, Toulouse, France, marx.m@chu-toulouse.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Marx
authors.forename: Frank
authors.initials: F
authors.lastname: Risi
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudé
authors.forename: Irfan
authors.initials: I
authors.lastname: Durmo
authors.forename: Christopher
authors.initials: C
authors.lastname: James
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lauwers
authors.forename: Olivier
authors.initials: O
authors.lastname: Deguine
authors.forename: Bernard
authors.initials: B
authors.lastname: Fraysse
mesh_terms: D001489:Basilar Membrane / Q000000981:diagnostic imaging* / Q000473:pathology; D003051:Cochlea / Q000000981:diagnostic imaging / Q000473:pathology; D019929:Cochlear Implantation; D003054:Cochlear Implants; D054893:Cone-Beam Computed Tomography; D004567:Electrodes, Implanted; D006801:Humans; D008953:Models, Anatomic; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D012533:Scala Tympani / Q000000981:diagnostic imaging* / Q000473:pathology; D013701:Temporal Bone / Q000000981:diagnostic imaging* / Q000473:pathology
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