3D curved multiplanar cone beam CT reconstruction for intracochlear position assessment of straight electrodes array. A temporal bone and clinical study.
A retrospective review of post-op cone beam CT (CBCT) of 8 adult patients and 14 fresh temporal bones that underwent cochlear implantation with straight flexible electrodes array was performed to determine if the position of a long and flexible electrodes array within the cochlear scalae could be reliably assessed with CBCT. An oto-radiologist and two otologists examined the images and assessed the electrodes position. The temporal bone specimens underwent histological analysis for confirm the exact position. The position of the electrodes was rated as scala tympani, scala vestibule, or intermediate position for the electrodes at 180°, 360° and for the apical electrode. In the patient group, for the electrodes at 180° all observers agreed for scala tympani position except for 1 evaluation, while a discrepancy in 3 patients both for the 360° and for the apical electrode assessment were found. In five temporal bones the evaluations were in discrepancy for the 180° electrode, while at 360° a disagreement between raters on the scalar positioning was seen in six temporal bones. A higher discrepancy between was found in assessment of the scalar position of the apical electrode (average pairwise agreement 45.4%, Fleiss k = 0.13). A good concordance was found between the histological results and the consensus between raters for the electrodes in the basal turn, while low agreement (Cohen's k 0.31, pairwise agreement 50%) was found in the identification of the apical electrode position confirming the difficulty to correct identify the electrode position in the second cochlear turn in temporal bones. In conclusion, CBCT is a reliable radiologic exam to correctly evaluate the position of a lateral wall flexible array in implanted patients using the proposed imaging reconstruction method, while some artefacts impede exact evaluation of the position of the apical electrode in temporal bone and other radiological techniques should be preferred in ex vivo studies.
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.|Department of Sense Organs, Sapienza University of Rome, Italy.
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De Seta
Department of Sense Organs, Sapienza University of Rome, Italy.
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Mancini
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.|Department of Sense Organs, Sapienza University of Rome, Italy.
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Russo
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.
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Torres
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.
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Mosnier
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.
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Bensimon
Department of Sense Organs, Sapienza University of Rome, Italy.
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De Seta
Inserm, UMR 957, Laboratory of Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumours, Nantes, France.
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Heymann
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.
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Sterkers
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.
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Bernardeschi
Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité Réhabilitation Chirurgicale Mini-invasive et Robotisée de l'Audition, Paris, France.|AP-HP, GHU Pitié-Salpêtrière, Service ORL, Otologie, Implants Auditifs et Chirurgie de la Base du Crâne, Paris, France.
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Nguyen
D002102:Cadaver; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D054893:Cone-Beam Computed Tomography; D004566:Electrodes; D006801:Humans; D021621:Imaging, Three-Dimensional; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000601:surgery
Cochlear implants; Cone Beam CT; Electrode position; Histology; Temporal bone