Anatomic Verification of a Novel Method for Precise Intrascalar Localization of Cochlear Implant Electrodes in Adult Temporal Bones Using Clinically Available Computed Tomography
Anatomic Verification of a Novel Method for Precise Intrascalar Localization of Cochlear Implant Electrodes in Adult Temporal Bones Using Clinically Available Computed Tomography
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DOI：
10.1002/lary.21104
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发表时间：
2010-11-01
期刊：
影响因子：
2.6
通讯作者：
Labadie, Robert F.
中科院分区：
文献类型：
--
作者：
Schuman, Theodore A.;Noble, Jack H.;Labadie, Robert F.
目标/假设：我们之前已经描述了一种新的，自动化的，非刚性的，基于模型的方法，用于使用临床可用的平板体积计算机断层扫描（fpVCT）来确定耳蜗植入体（CI）电极阵列在人颞骨内的耳内位置。我们试图通过将结果与尸体bone.Study设计：基础science.Methods：七个成人尸体颞骨的CI阵列的解剖显微解剖相关联来验证这种方法：在电极插入之前和之后使用fpVCT成像。使用颅内解剖的统计模型，采用主动形状模型优化方法来识别干预前fpVCT上的鼓阶和前庭。通过在介入后扫描上识别其中线并使用刚性配准将其叠加到介入前图像上来估计阵列位置。然后，标本显微解剖，以证明实际的阵列position.Results：使用显微解剖作为确定电极位置的标准，自动识别的基底膜再加上postintervention fpVCT电极位置识别准确地描绘了阵列的位置在所有七个骨。在四个标本中，阵列仍然在鼓阶内，在三个，基底膜breakth.Conclusions：我们已经解剖学验证了这种自动化的方法，预测使用CT的CI阵列的intraascalar位置。使用该算法和介入前后CT，可以在临床环境中获得关于植入物位置和预期听力学结果的快速反馈。
Objectives/Hypothesis: We have previously described a novel, automated, nonrigid, model-based method for determining the intrascalar position of cochlear implant (CI) electrode arrays within human temporal bones using clinically available, flat-panel volume computed tomography (fpVCT). We sought to validate this method by correlating results with anatomic microdissection of CI arrays in cadaveric bones.Study Design: Basic science.Methods: Seven adult cadaveric temporal bones were imaged using fpVCT before and after electrode insertion. Using a statistical model of intracochlear anatomy, an active shape model optimization approach was employed to identify the scalae tympani and vestibuli on the preintervention fpVCT. The array position was estimated by identifying its mid-line on the postintervention scan and superimposing it onto the preintervention images using rigid registration. Specimens were then microdissected to demonstrate the actual array position.Results: Using microdissection as the standard for ascertaining electrode position, automatic identification of the basilar membrane coupled with postintervention fpVCT for electrode position identification accurately depicted the array location in all seven bones. In four specimens, the array remained within the scala tympani; in three, the basilar membrane was breached.Conclusions: We have anatomically validated this automated method for predicting the intrascalar location of CI arrays using CT. Using this algorithm and pre- and postintervention CT, rapid feedback regarding implant location and expected audiologic outcomes could be obtained in clinical settings.