A new method of preoperative assessment of correct electrode array alignment based on post-operative measurements in a cochlear implanted cohort.

Autor: Horvath B; Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary. horvath.bence.3@stud.u-szeged.hu.; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary. horvath.bence.3@stud.u-szeged.hu., Perenyi A; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary., Molnar FA; Faculty of Medicine, University of Szeged, Szeged, Hungary., Nagy R; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary., Csanady M; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary., Kiss JG; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary., Rovo L; Department of Oto-Rhino- Laryngology and Head- Neck Surgery, University of Szeged, Szeged, Hungary.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2022 Dec; Vol. 279 (12), pp. 5631-5638. Date of Electronic Publication: 2022 Jun 21.
DOI: 10.1007/s00405-022-07421-8
Abstrakt: Purpose: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
(© 2022. The Author(s).)
Databáze: MEDLINE
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