Clinical values and advances in computed tomography evaluation after cochlear implantation

doi:10.3969/j.issn.1674-8115.2023.12.001

Abstract

Abstract:

Cochlear implantation has been a standard rehabilitation for children and adult patients with severe to profound sensorineural deafness. The intracochlear localization of the electrode array is one of the key factors related to the postoperative auditory and speech outcomes. Preservation of the residual hearing is related to the trauma to the inner ear structures caused in the insertion process. Optimal insertion depth and positioning of the electrode array is important for frequency discrimination. The post-operative position of the electrode array is evaluated by using plain X ray or computed tomography (CT). Compared to the plain X ray, CT produces three-dimensional (3D) imaging. With the application of post-operative CT evaluation, the integrity of the electrode array can be verified for surgical safety and improving programming accuracy. Different 3D reconstruction techniques and methods based on the post-operative CT imaging have been proposed to facilitate the precise recognition of position of each electrode, thus helpful to evaluate the possible insertion trauma to inner ear structures and the potential effect on auditory and speech outcomes. The post-operative CT evaluation has helped the electrode array design, brought progress to the soft surgery procedure and promoted new technologies such as robotic surgery and navigation. Therefore, it is getting more and more attention. This article reviews the clinical application values and the progress of techniques in post-operative CT evaluation of cochlear implantation.

Key words: cochlear implantation, computed tomography (CT), multiplanar reconstruction, 3D fusion reconstruction

CLC Number:

R764.35

GU Wenxi, JIA Huan, WU Hao. Clinical values and advances in computed tomography evaluation after cochlear implantation[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(12): 1463-1469.

Figures/Tables 3

TrendMD

References 37

1	O'CONNELL B P, HUNTER J B, WANNA G B. The importance of electrode location in cochlear implantation[J]. Laryngoscope Investig Otolaryngol, 2016, 1(6): 169-174.
2	XU J, XU S, COHEN L, et al. Cochlear view: postoperative radiography for cochlear implantation[J]. Am J Otolaryngol, 2000, 21(1): 49-56.
3	VERBIST B M, FRIJNS J H M, GELEIJNS J, et al. Multisection CT as a valuable tool in the postoperative assessment of cochlear implant patients[J]. AJNR Am J Neuroradiol, 2005, 26(2): 424-429.
4	RUIVO J, MERMUYS K, BACHER K, et al. Cone beam computed tomography, a low-dose imaging technique in the postoperative assessment of cochlear implantation[J]. Otol Neurotol, 2009, 30(3): 299-303.
5	JIA H, TORRES R, NGUYEN Y, et al. Intraoperative conebeam CT for assessment of intracochlear positioning of electrode arrays in adult recipients of cochlear implants[J]. AJNR Am J Neuroradiol, 2018, 39(4): 768-774.
6	LOUBELE M, JACOBS R, MAES F, et al. Image quality vs radiation dose of four cone beam computed tomography scanners[J]. Dentomaxillofac Radiol, 2008, 37(6): 309-318.
7	GU W X, DAOUDI H, LAHLOU G, et al. Auditory outcomes after scala vestibuli array insertion are similar to those after scala tympani insertion 1 year after cochlear implantation[J]. Eur Arch Otorhinolaryngol, 2023. DOI: 10.1007/s00405-023-08107-5.
8	DHANASINGH A, JOLLY C. Review on cochlear implant electrode array tip fold-over and scalar deviation[J]. J Otol, 2019, 14(3): 94-100.
9	PAPSIN B C. Cochlear implantation in children with anomalous cochleovestibular anatomy[J]. Laryngoscope, 2005, 115(S106): 1-26.
10	BIRMAN C S, BREW J A, GIBSON W P R, et al. CHARGE syndrome and Cochlear implantation: difficulties and outcomes in the paediatric population[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(4): 487-492.
11	TODT I, RADEMACHER G, ERNST A. Identification and revision of a displaced cochlear implant electrode in the internal auditory canal[J]. Cochlear Implants Int, 2013, 14(4): 236-239.
12	PAU H, PARKER A, SANLI H, et al. Displacement of electrodes of a cochlear implant into the vestibular system: intra- and postoperative electrophysiological analyses[J]. Acta Otolaryngol, 2005, 125(10): 1116-1118.
13	GÖZEN E D, TEVETOĞLU F, YENER H M, et al. Extra-cochlear insertion in cochlear implantation: a potentially disastrous condition[J]. J Int Adv Otol, 2019, 15(3): 358-363.
14	ISHIYAMA A, RISI F, BOYD P. Potential insertion complications with cochlear implant electrodes[J]. Cochlear Implants Int, 2020, 21(4): 206-219.
15	VASHISHTH A, FULCHERI A, GUIDA M, et al. Incomplete and false tract insertions in cochlear implantation: retrospective review of surgical and auditory outcomes[J]. Eur Arch Otorhinolaryngol, 2018, 275(5): 1059-1068.
16	DHANASINGH A, JOLLY C. An overview of cochlear implant electrode array designs[J]. Hear Res, 2017, 356: 93-103.
17	HILLY O, SMITH L, HWANG E, et al. Depth of cochlear implant array within the cochlea and performance outcome[J]. Ann Otol Rhinol Laryngol, 2016, 125(11): 886-892.
18	WANNA G B, NOBLE J H, GIFFORD R H, et al. Impact of intrascalar electrode location, electrode type, and angular insertion depth on residual hearing in cochlear implant patients: preliminary results[J]. Otol Neurotol, 2015, 36(8): 1343-1348.
19	CARLSON M L, DRISCOLL C L W, GIFFORD R H, et al. Implications of minimizing trauma during conventional cochlear implantation[J]. Otol Neurotol, 2011, 32(6): 962-968.
20	IBRAHIM H N, HELBIG S, BOSSARD D, et al. Surgical trauma after sequential insertion of intracochlear catheters and electrode arrays (a histologic study)[J]. Otol Neurotol, 2011, 32(9): 1448-1454.
21	DAĞKIRAN M, TARKAN Ö, SÜRMELIOĞLU Ö, et al. Management of complications in 1 452 pediatric and adult cochlear implantations[J]. Turk Arch Otorhinolaryngol, 2020, 58(1): 16-23.
22	DIETZ A, WENNSTRÖM M, LEHTIMÄKI A, et al. Electrode migration after cochlear implant surgery: more common than expected?[J]. Eur Arch Otorhinolaryngol, 2016, 273(6): 1411-1418.
23	DEES G, SMITS J J, JANSSEN A M L, et al. A mid-scala cochlear implant electrode design achieves a stable post-surgical position in the cochlea of patients over time: a prospective observational study[J]. Otol Neurotol, 2018, 39(4): e231-e239.
24	TAN H Y, YAO J J, LI Y, et al. Radiological and audiological outcomes of the LISTENT LCI-20PI cochlear implant device[J]. Otol Neurotol, 2021, 42(4): 524-531.
25	DAOUDI H, LAHLOU G, TORRES R, et al. Robot-assisted cochlear implant electrode array insertion in adults: a comparative study with manual insertion[J]. Otol Neurotol, 2021, 42(4): e438-e444.
26	JIA H, PAN J X, GU W X, et al. Robot-assisted electrode array insertion becomes available in pediatric cochlear implant recipients: first report and an intra-individual study[J]. Front Surg, 2021, 8: 695728.
27	ALJAZEERI I, HAMED N, ABDELSAMAD Y, et al. Anatomy-based frequency allocation in cochlear implantation: the importance of cochlear coverage[J]. Laryngoscope, 2022, 132(11): 2224-2231.
28	CANFAROTTA M W, DILLON M T, BUSS E, et al. Frequency-to-place mismatch: characterizing variability and the influence on speech perception outcomes in cochlear implant recipients[J]. Ear Hear, 2020, 41(5): 1349-1361.
29	DI MARO F, CARNER M, SACCHETTO A, et al. Frequency reallocation based on cochlear place frequencies in cochlear implants: a pilot study[J]. Eur Arch Otorhinolaryngol, 2022, 279(10): 4719-4725.
30	TORRES R, DROUILLARD M, DE SETA D, et al. Cochlear implant insertion axis into the basal turn: a critical factor in electrode array translocation[J]. Otol Neurotol, 2018, 39(2): 168-176.
31	DE SETA D, MANCINI P, RUSSO F Y, et al. 3D curved multiplanar cone beam CT reconstruction for intracochlear position assessment of straight electrodes array. A temporal bone and clinical study[J]. Acta Otorhinolaryngol Ital, 2016, 36(6): 499-505.
32	SIPARI S, ISO-MUSTAJÄRVI M, LÖPPÖNEN H, et al. The insertion results of a mid-scala electrode assessed by MRI and CBCT image fusion[J]. Otol Neurotol, 2018, 39(10): e1019-e1025.
33	DRAGOVIC A S, STRINGER A K, CAMPBELL L, et al. Co-registration of cone beam CT and preoperative MRI for improved accuracy of electrode localization following cochlear implantation[J]. Cochlear Implants Int, 2018, 19(3): 147-152.
34	贾欢, 谭皓月, 张治华, 等. 精准人工耳蜗电极鼓阶植入: 技术报告及6年回顾[C]//中华医学会. 中华医学会第十九次全国耳鼻咽喉头颈外科学学术会议论文汇编. 北京: 中华医学会, 2022: 612.
	JIA H, TAN H Y, ZHANG Z H, et al. Precise cochlear electrode array insertion into the scala tympani: technical report and 6-year review[C]//Chinese Medical Association. Thesis compilation of The 19th National Academic Meeting of Chinese Society of Otolaryngology-Head and Neck Surgery. Beijing: Chinese Medical Association, 2022: 612.
35	CAKIR A, LABADIE R F, ZUNIGA M G, et al. Evaluation of rigid cochlear models for measuring cochlear implant electrode position[J]. Otol Neurotol, 2016, 37(10): 1560-1564.
36	DEMARCY T, VANDERSTEEN C, GUEVARA N, et al. Automated analysis of human cochlea shape variability from segmented μCT images[J]. Comput Med Imaging Graph, 2017, 59: 1-12.
37	TORRES R, TINEVEZ J Y, DAOUDI H, et al. Best fit 3D basilar membrane reconstruction to routinely assess the scalar position of the electrode array after cochlear implantation[J]. J Clin Med, 2022, 11(8): 2075.

[1]	WANG Tao, ZHANG Chen-cheng, LI Dian-you, SUN Bo-min, FU Meng. Imaging law of postoperative electrode locations in deep brain stimulation for Parkinsons disease [J]. , 2020, 40(1): 64-.
[2]	PANG Shuai1, 2, CAI Xiao-ting1, 2, CHENG Ting1, 2, ZHANG Neng-chong3, NI Jin-hua2, 4, CHENG Qi-jian1, 2. Clinical value of low attenuation area ratio and lung volume on CT in evaluating severity of spirometric abnormality [J]. , 2019, 39(11): 1284-.