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Abstract
Objective
There is still a lack in precise postoperative evaluation of the cochlea because of strong artifacts. This study aimed to improve accuracy of postoperative two-turn (2TL) and cochlear duct length (CDL) measurements by applying flat-panel volume computed tomography (fpVCT), secondary reconstruction (fpVCTSECO) and three-dimensional curved multiplanar reconstruction.
Methods
First, 10 temporal bone specimens with or without electrode were measured in multi-slice computed tomography (MSCT), fpVCT and fpVCTSECO and compared to high-resolution micro-CT scans. Later, pre- and postoperative scans of 10 patients were analyzed in a clinical setting.
Results
Concerning 2TL, no statistically significant difference was observed between implanted fpVCTSECO and nonimplanted micro-CT in 10 temporal bone specimens. In contrast, there was a significant discrepancy for CDL (difference: −0.7 mm, P = 0.004). Nevertheless, there were no clinically unacceptable errors (±1.5 mm). These results could be confirmed in a clinical setting. Using fpVCTSECO, CDL was slightly underestimated postoperatively (difference: −0.5 mm, P = 0.002) but without any clinically unacceptable errors.
Conclusion
fpVCTSECO can be successfully applied for a precise measurement of the cochlear lengths pre- and postoperatively. However, users must be aware of a slight systematic underestimation of CDL postoperatively. These results may help to refine electrode selection and frequency mapping.
Acknowledgements
The authors thank the team of the Comprehensive Hearing Center at the University of Würzburg for the extensive help.
Disclaimer statements
Contributors None.
Funding None.
Conflicts of interest None.
Ethics approval The study was approved by the ethical commission of the university medical center of Würzburg (Nr. 2019020401).
Additional information
Notes on contributors
Philipp Schendzielorz
Philipp Schendzielorz is an MD and a consultant at the Department of Oto-Rhino-Laryngology of the University of Würzburg. He graduated 2010 at the University of Mainz in medicine and finished his residency in 2016. He was appointed in 2016 as consultant. In 2020, he received his venia legendi (habilitation). At the moment, he is senior physician at the Department of Oto-Rhino-Laryngolgy of the University of Würzburg and leading physician of the section ‘sleep medicine’. His main areas of research are otology, inner ear biology, allergy and sleep medicine.
Lukas Ilgen
Lukas Ilgen is a candidate of medicine (cand. med.) at the Julius Maximilian's University of Würzburg. He passed his second state examination in 2021. Currently, he does his doctoral degree at the Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery of the University of Würzburg in the field of cochlear implantation and temporal bone imaging.
Franz-Tassilo Müller-Graff
Franz-Tassilo Müller-Graff is an MD and an intern at the Department of Oto-Rhino-Laryngology of the University of Würzburg. He graduated 2016 at the University of Rostock in medicine and received his doctoral degree in 2019. After 1 1/2 years as an assistant physician in trauma and orthopedic surgery at the University Hospital of Augsburg, he began training as a specialist in ENT at the University Hospital of Würzburg in 2019. At the moment, he is medically and scientifically active in the section ‘hearing prostheses and cochlear implantation’. He is the author/coauthor of currently 4 peer-reviewed articles.
Laurent Noyalet
Laurent Noyalet is a postgraduate at the Department of Oto-Rhino-Laryngology of the University of Würzburg. He finished his dentistry studies in 2019 and then started with his thesis about the vestibular aqueduct and Meniere's Disease under the supervision of Dr. Rak.
Johannes Völker
Johannes Voelker is an ENT specialist at the Würzburg University Hospital. He graduated from the University of Würzburg with a degree in human medicine in 2012. He worked in the ENT research laboratory from 2009 to 2015 on his dissertation on neural stem cells of the rat cochlear nucleus. Since 2018 he has been holding a scholarship of the Clinician Scientist Program of the IZKF Würzburg and finished his residency in 2019. His research focuses on otology and inner ear biology for regenerative approaches to the auditory pathway and the cochlear sensory epithelium. He is the author/coauthor of 20 peer-reviewed articles.
Johannes Taeger
Johannes Taeger is a MD and a consultant at the Department for Oto-Rhino-Laryngology at the University of Würzburg. He completed his medical degree at the University of Regensburg in 2011 and was appointed an ENT consultant in 2017. Scientifically, he is mainly active in inner ear research, oncology, toxicology and digitization of ENT medicine. He is the author/coauthor of 8 peer-reviewed articles.
Rudolf Hagen
Rudolf Hagen holds the chair in Oto-Rhino-Laryngology (ORL) at the University of Würzburg (Germany) since 2005. He graduated in medicine 1983 (MD) and finished his residency in ORL 1988. Following habilitation in 1991 (assistant professor), he became medical director of the ORL Department at the Katharinenhospital Stuttgart (Germany) in 1998 (associate professor University of Tübingen, Germany). 2005 he was appointed head of the ORL Department at the University of Würzburg and Chairman. He acquired several additional qualifications in Plastic and Reconstructive Surgery (1992), Allergology (1995) and Special Head and Neck Surgery (1996). He is author/coauthor in more than 200 peer-reviewed articles. His actual RG-score is 44.45 (ResearchGate), the h-index 27.
Tilmann Neun
Tilmann Neun has been working at the Department of Radiology of the University Hospital Jena since 2007, at the Department of Radiology of the Hospital Weimar since 2012 and at the Department of Neuroradiology of the University Hospital Würzburg since 2017. He completed his studies in human medicine at the University of Würzburg in 2006 and granted a degree of PhD in 2010. In 2014, he graduated as a specialist in radiology.
Simon Zabler
Simon Zabler is managing the X-ray imaging group at the Fraunhofer Institute for Integrated Circuits IIS. Meanwhile, he is teaching experimental physics, signal processing and synchrotron science at Julius Maximilian's University Würzburg. Dr. Zabler graduated Master of Science from Grenoble's Physics School and achieved the German-French double-diploma with distinction from Karlsruhe University. He received his doctor degree from Technical University of Berlin in 2007. After a postdoc at Max Planck Potsdam and two years of teaching assistant at TU Berlin, Dr. Zabler joined Fraunhofer IIS and the Würzburg Chair of X-ray Microscopy in 2011. He is a renowned expert in X-ray imaging and material science, as well as author/coauthor of more than 70 peer-reviewed publications.
Daniel Althoff
Daniel Althoff graduated 2014 at the University of Würzburg in physics. He is a scientific assistant at the Development Center X-ray Technology EZRT, a division of Fraunhofer Institute for Integrated Circuits IIS, since 2014 and is working in the field of micro-CT and x-ray microscopy.
Kristen Rak
Kristen Rak is an MD and a consultant at the Department of Oto-Rhino-Laryngology of the University of Würzburg. He graduated 2008 at the University of Würzburg in medicine and finished his residency in 2014. He was appointed in 2015 as consultant. In 2016, he received his venia legendi (habilitation). At the moment, he is the leading physician of the section ‘hearing prostheses and cochlear implantation’. His clinical specialties are in the area of otology, especially cochlear implants, active middle ear implants and middle ear surgery. He is the author/coauthor of 40 peer-reviewed articles.