Radio logic and Functional Evaluation of Electrode Dislocation from the Scala Tympani to the Scala Vestibuli in Patients with Cochlear Implants
Radio logic and Functional Evaluation of Electrode Dislocation from the Scala Tympani to the Scala Vestibuli in Patients with Cochlear Implants
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DOI：
10.3174/ajnr.a4189
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发表时间：
2015-02-01
影响因子：
3.5
通讯作者：
Widmann, G.
中科院分区：
文献类型：
--
作者：
Fischer, N.;Pinggera, L.;Widmann, G.
背景和目的：耳蜗植入后电极的定位似乎对听觉结果有影响，锥束CT已成为一种可靠的方法，用于可视化耳蜗内的电极阵列位置。本回顾性研究的目的是评估的频率和各种电极和手术方法的标量脱位的临床影响，并评估其对听觉outcome.MATERIALS和METHODS的影响：本回顾性单中心研究分析了连续系列的63个耳蜗植入与各种直电极。通过使用多平面重建的锥束CT图像来评价电极阵列的放置。在听觉效果方面，我们比较了植入后第6、12和24周的辅助听阈和最大舒适响度水平的电荷单位。在所有情况下，电极阵列在电极插入的45 °内穿透基底膜。3例耳蜗造口均在前45段脱位。没有注意到听力差异，但最大舒适响度水平的收费单位似乎随着时间的推移而增加，在dislocations.Conclusions：锥束CT图像检测到的各种直电极的颅内脱位率是相对较低的。标量脱位可能不会对听阈产生负面影响，但可能需要增加必要的刺激电荷，并应由放射科医生报告。
BACKGROUND AND PURPOSE: Localization of the electrode after cochlear implantation seems to have an impact on auditory outcome, and conebeam CT has emerged as a reliable method for visualizing the electrode array position within the cochlea. The aim of this retrospective study was to evaluate the frequency and clinical impact of scalar dislocation of various electrodes and surgical approaches and to evaluate its influence on auditory outcome.MATERIALS AND METHODS: This retrospective single-center study analyzed a consecutive series of 63 cochlear implantations with various straight electrodes. The placement of the electrode array was evaluated by using multiplanar reconstructed conebeam CT images. For the auditory outcome, we compared the aided hearing thresholds and the charge units of maximum comfortable loudness level at weeks 6, 12, and 24 after implantation.RESULTS: In 7.9% of the cases, the electrode array showed scalar dislocation. In all cases, the electrode array penetrated the basal membrane within 45 of the electrode insertion. All 3 cases of cochleostomy were dislocated in the first 45 segment. No hearing differences were noted, but the charge units of maximum comfortable loudness level seemed to increase with time in patients with dislocations.CONCLUSIONS: The intracochlear dislocation rate of various straight electrodes detected by conebeam CT images is relatively low. Scalar dislocation may not negatively influence the hearing threshold but may require an increase of the necessary stimulus charge and should be reported by the radiologist.