Scalar Localization by Cone-Beam Computed Tomography of Cochlear Implant Carriers: A Comparative Study Between Straight and Periomodiolar Precurved Electrode Arrays
Scalar Localization by Cone-Beam Computed Tomography of Cochlear Implant Carriers: A Comparative Study Between Straight and Periomodiolar Precurved Electrode Arrays
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DOI：
10.1097/mao.0000000000000705
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发表时间：
2015-03-01
影响因子：
2.1
通讯作者：
Schmerber, Sebastien
中科院分区：
文献类型：
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作者：
Boyer, Eric;Karkas, Alexandre;Schmerber, Sebastien
目的：利用锥形束ct （cone-beam computed tomography， CBCT）图像分析比较预弯曲与直柔性人工耳蜗电极阵列脱位的发生率。研究设计：连续非随机病例比较研究。设置：三级转诊中心。患者：人工耳蜗术后患者的CBCT图像分析。干预：植入来自两家不同制造商的预弯曲和直柔性电极阵列。多数病例采用圆窗置入。2例需要行耳蜗造口术。在冠状位斜、矢状位斜和轴位斜上重建患者的CBCT图像。主要观察指标：测定植入深度、角度和中耳级到前庭级的脱位发生率。结果：分析54例患者（61个电极阵列）的CBCT图像及脱位发生率。31例患者植入预弯曲的磨牙周围电极阵列，30例患者植入直柔性电极阵列。两组共发生9例（15%）标量位错。预弯曲排列组有8例（26%）位错，直排列组有1例（3%）位错。在预弯曲阵列组中，位错发生在插入深度角在170至190度之间，而在直阵列组中，位错发生在约370度。结论：预曲阵脱位通常发生在耳蜗基底转的上升部。直线柔性电极阵列的位错发生率较低，并且与臼齿周围预弯曲电极阵列相比，直线柔性电极阵列在鼓膜内受限位置的可能性更高。
Objective: To compare the incidence of dislocation of precurved versus straight flexible cochlear implant electrode arrays using cone-beam computed tomography (CBCT) image analyses.Study Design: Consecutive nonrandomized case-comparison study.Settings: Tertiary referral center.Patients: Analyses of patients' CBCT images after cochlear implant surgery.Intervention(s): Precurved and straight flexible electrode arrays from two different manufacturers were implanted. A round window insertion was performed in most cases. Two cases necessitated a cochleostomy. The patients' CBCT images were reconstructed in the coronal oblique, sagittal oblique, and axial oblique section.Main Outcome Measures: The insertion depth angle and the incidence of dislocation from the scala tympani to the scala vestibuli were determined.Results: The CBCT images and the incidence of dislocation were analyzed in 54 patients (61 electrode arrays). Thirty-one patients were implanted with a precurved perimodiolar electrode array and 30 patients with a straight flexible electrode array. A total of nine (15%) scalar dislocations were observed in both groups. Eight (26%) scalar dislocations were observed in the precurved array group and one (3%) in the straight array group. Dislocation occurred at an insertion depth angle between 170 and 190 degrees in the precurved array group and at approximately 370 degrees in the straight array group.Conclusion: With precurved arrays, dislocation usually occurs in the ascending part of the basal turn of the cochlea. With straight flexible electrode arrays, the incidence of dislocation was lower, and it seems that straight flexible arrays have a higher chance of a confined position within the scala tympani than perimodiolar precurved arrays.