A new method of preoperative assessment of correct electrode array alignment based on post-operative measurements in a cochlear implanted cohort
Tóm tắt
During cochlear implantation surgery, a range of complications may occur such as tip fold-over. We recently developed a method to estimate the insertion orientation of the electrode array. The aim of the study was to determine the optimal angle of orientation in a cohort of cochlear implanted patients. On eighty-five CT scans (80 uncomplicated insertions and 5 cases with tip fold-over), location of the electrode array’s Insertion Guide (IG), Orientation marker (OM) and two easily identifiable landmarks (the round window (RW) and the incus short process (ISP)) were manually marked. The angle enclosed by ISP-RW line and the Cochlear™ Slim Modiolar electrode array’s OM line determined the electrode array insertion angle. The average insertion angle was 45.0–47.2° ± 10.4–12° SD and was validated with 98% confidence interval. Based on the measurements obtained, patients’ sex and age had no impact on the size of this angle. Although the angles of the tip fold-over cases (44.9°, 46.9°, 34.2°, 54.3°, 55.9°) fell within this average range, the further it diverted from the average it increased the likelihood for tip fold-over. Electrode array insertion in the individually calculated angle relative to the visible incus short process provides a useful guide for the surgeon when aiming for the optimal angle, and potentially enhances good surgical outcomes. Our results show that factors other than the orientation angle may additionally contribute to failures in implantation when the Slim Modiolar electrode is used.
Tài liệu tham khảo
Deep NL, Dowling EM, Jethanamest D, Carlson ML (2019) Cochlear implantation: an overview. J Neurol Surg B Skull Base 80(2):169–177
Klabbers TM, Heutink F, Huinck WJ, van der Woude WJ, Verbist BM, Mylanus EAM (2022) Intracochlear electrode array position and cochlear implant outcomes using the nucleus Slim Modiolar electrode and the extended round window approach: a follow-up study. Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-021-07247-w
Zuniga MG, Rivas A, Hedley-Williams A, Gifford RH, Dwyer R, Dawant BM, Sunderhaus LW, Hovis KL, Wanna GB, Noble JH, Labadie RF (2017) Tip fold-over in cochlear implantation: case series. Otol Neurotol 38(2):199–206
Eshraghi AA, Nazarian R, Telischi FF, Rajguru SM, Truy E, Gupta C (2012) The cochlear implant: historical aspects and future prospects. Anat Rec 295(11):1967–1980
Perenyi A, Toth F, Dimak B, Nagy R, Schoerg P, Jori J, Kiss JG, Sprinzl G, Csanady M, Rovo L (2019) Electrophysiological measurements with electrode types of different perimodiolar properties and the same cochlear implant electronics—a retrospective comparison study. J Otolaryngol Head Neck Surg 48(1):46
McJunkin JL, Durakovic N, Herzog J, Buchman CA (2018) Early outcomes with a slim, Modiolar cochlear implant electrode array. Otol Neurotol 39(1):e28–e33
Shaul C, Weder S, Tari S, Gerard JM, O’Leary SJ, Briggs RJ (2020) Slim, Modiolar cochlear implant electrode: melbourne experience and comparison with the contour perimodiolar electrode. Otol Neurotol 41(5):639–643
Dhanasingh A, Jolly C (2019) Review on cochlear implant electrode array tip fold-over and scalar deviation. J Otol 14(3):94–100
Halawani RT, Dhanasingh A (2020) New classification of cochlear hypoplasia type malformation: relevance in cochlear implantation. J Int Adv Otol 16(2):153–157
Bruns N (2019) 3D Slicer: universal 3D visualization software. Unfallchirurg 122(8):662–663
Horváth Bence PÁ, Anna MF, Miklós C, Géza KJ, László R (2021) A new method to determine the optimal orientation of Slim Modiolar cochlear implant electrode array insertion. Clin Neurosci 74(5–6):191–195
Ambrose SE, Todd NW Jr (2018) “Cochlear view” plain radiograph: a simple reliable positioning method. Cochlear Implants Int 19(2):100–103
Braga J, Samir C, Risser L, Dumoncel J, Descouens D, Thackeray JF, Balaresque P, Oettle A, Loubes JM, Fradi A (2019) Cochlear shape reveals that the human organ of hearing is sex-typed from birth. Sci Rep 9(1):10889
Wimmer W, Venail F, Williamson T, Akkari M, Gerber N, Weber S, Caversaccio M, Uziel A, Bell B (2014) Semiautomatic cochleostomy target and insertion trajectory planning for minimally invasive cochlear implantation. Biomed Res Int 2014:596498
Pile J and Simaan N (2013) Characterization of friction and speed effects and methods for detection of cochlear implant electrode tip fold-over. In: 2013 IEEE International Conference on Robotics and Automation, pp 4409–4414
Meshik X, Holden TA, Chole RA, Hullar TE (2010) Optimal cochlear implant insertion vectors. Otol Neurotol 31(1):58–63
Cochlear™ Nucleus® CI632 cochlear implant with Slim Modiolar electrode, Physician’s Guide, Cochlear™, Canada https://www.cochlear.com/ifu/documents/d1144283-en-ci632
O’Connell BP, Hunter JB, Wanna GB (2016) The importance of electrode location in cochlear implantation. Laryngoscope Investig Otolaryngol 1(6):169–174
Zuniga MG, Böttcher G, Schell V, Lenarz T, Rau TS (2021) Illustrating orientation changes of the insertion trajectory during cochlear implant electrode array insertion. Curr Direct Biomed Eng 7(2):113–116
Jia H, Pan J, Gu W, Tan H, Chen Y, Zhang Z, Jiang M, Li Y, Sterkers O, Wu H (2021) Robot-Assisted electrode array insertion becomes available in pediatric cochlear implant recipients: first report and an intra-individual study. Front Surg 8:695728
Torres R, Jia H, Drouillard M, Bensimon JL, Sterkers O, Ferrary E, Nguyen Y (2018) An optimized robot-based technique for cochlear implantation to reduce array insertion trauma. Otolaryngol Head Neck Surg 159(5):900–907
Torres R, Daoudi H, Lahlou G, Sterkers O, Ferrary E, Mosnier I, Nguyen Y (2021) Restoration of high frequency auditory perception after robot-assisted or manual cochlear implantation in profoundly deaf adults improves speech recognition. Front Surg. https://doi.org/10.3389/fsurg.2021.729736