Comparison Between Transimpedance Matrix (TIM) Measurement and X-ray Fluoroscopy for Intraoperative Electrode Array Tip Fold-Over Detection
| Autor: | Emmanuel A. M. Mylanus, Wendy J. Huinck, Tim M Klabbers |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Transimpedance amplifier
medicine.medical_treatment Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] All institutes and research themes of the Radboud University Medical Center Cochlear implant Electrode array Humans Medicine Fluoroscopy In patient Cochlear implantation Retrospective Studies medicine.diagnostic_test business.industry X-Rays Outcome measures X-ray Cochlear Implantation Sensory Systems Cochlea Electrodes Implanted Cochlear Implants Otorhinolaryngology Neurology (clinical) business Nuclear medicine |
| Zdroj: | Otology & Neurotology, 42, E1457-E1463 Otology & Neurotology, 42, 10, pp. E1457-E1463 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | OBJECTIVE The aim of this study was to compare Transimpedance Matrix (TIM-) measurement and X-ray fluoroscopy for the intraoperative detection of electrode array tip fold-over in cochlear implant recipients. STUDY DESIGN Retrospective agreement study. SETTING Tertiary referral hospital. PATIENTS Forty-two patients (47 ears) consecutively implanted with the Slim Modiolar Electrode. INTERVENTIONS Five raters, with different levels of clinical experience, individually retrospectively evaluated the TIM-heatmaps and X-ray fluoroscopy images of all patients included in this study for electrode array tip fold-over. MAIN OUTCOME MEASURES Agreement between raters' individual evaluation and the diagnosis given during clinical intraoperative evaluation for both modalities, as well as the inter-method agreement between TIM-measurement and fluoroscopy, and the inter-rater agreement for both modalities. RESULTS A tip fold-over was found in three of the forty-seven implantations (6.4%) included in this study. The average agreement between raters' evaluation and the intraoperative evaluation was 88% (Cohens κ = 0.378) for fluoroscopy and 99% (Cohens κ = 0.915) for TIM-measurement. Two raters misdiagnosed at least one tip fold-over as being correctly positioned when evaluating the fluoroscopy images (1/3 and 3/3, respectively). Each of the raters correctly detected all three tip fold-overs using the TIM-heatmaps. The inter-rater agreement for fluoroscopy was classified as "fair" (Fleiss' κ = 0.286), while the inter-rater agreement for TIM-measurement was classified as "near-perfect" (Fleiss' κ = 0.850). CONCLUSIONS TIM-measurement has a high potential to replace X-ray fluoroscopy for intraoperatively detecting electrode array tip fold-over in cochlear implantation, especially in patients implanted with flexible, precurved arrays. |
| Databáze: | OpenAIRE |
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