Abstract
Background: Imaging of cochlear implant (CI) electrode arrays (EAs) consists of intraoperative fluoroscopy to rule out tip fold-over and/or post-operative computerized tomography (CT) if concern exists regarding extrusion or misplacement of the EA. Intraoperative CT (iCT) can satisfy these current needs and enables specification of final intracochlear position.
Aims/objectives: To describe iCT scanning of CI recipients at an academic medical center.
Materials and methods: iCT was used to scan CI recipients within the operating room before recovering from general anesthesia.
Results: In fiscal year 2019, 301 CI were placed (83 children, 218 adult). One hundred, seventy-five iCTs were performed (58% of total CIs) of which 52 were children (63% of pediatric CIs) and 123 were adult (57% of adult CIs). Of 7 CI surgeons, use of iCT ranged from 14% to 100% (mean 60%). Four tip fold-overs were identified and corrected intraoperatively. Surgeons reported using the images to improve technique (i.e. pulling back precurved EAs to improve perimodiolar positioning).
Conclusion and significance: The current standard of care for CI is to insert EAs without feedback as to final location. iCT provides surgeons with rapid post-insertion feedback which allows detection and correction of suboptimally placed EAs as well as refinement of surgical technique.
Chinese abstract
背景:人工耳蜗植入(CI)电极阵列成像术包括术中透视以排除尖端折叠和/或术后计算机断层扫描(CT), 如果担心对阵列的挤压或错位。术中CT(iCT)可以满足这些需求, 并能确定最终耳蜗内位置。
目的:描述在学术医疗中心对CI接受者进行iCT扫描的情况。
材料与方法:在手术室内, 采用iCT对CI接受者进行全身麻醉恢复前的扫描。
结果:在2019财政年度, 共植入301个CI(83名儿童, 218名成人)。共进行了175例iCT(占总CIs的58%), 其中儿童52例(占儿童CIs的63%), 成人123例(占成人CIs的57%)。在7名CI外科医生中, iCT的使用率从13.5%到100%(平均60%)。术中发现并纠正了四个叶尖折叠。外科医生报告使用这些图像可以改进技术(即拉回预弯电极以改善近蜗轴定位)。
结论及意义:目前CI的护理标准是在没有关于最终位置的反馈的情况下插入电极阵列。iCT为外科医生提供了快速的插入后反馈, 允许检测和纠正放置欠佳的EA, 并改进手术技术。
Disclosure statement
No potential conflict of interest was reported by the authors.