Intraoperative Evaluation of Cochlear Implant Electrodes Using Mobile Cone-Beam Computed Tomography
Intraoperative Evaluation of Cochlear Implant Electrodes Using Mobile Cone-Beam Computed Tomography
复制标题
使用移动锥形束计算机断层扫描对人工耳蜗植入电极进行术中评估
DOI：
10.1097/mao.0000000000002097
复制
发表时间：
2019
期刊：
影响因子：
2.1
通讯作者：
K.
中科院分区：
文献类型：
--
作者：
1.Yamamoto;N.;Okano;T.;Yamazaki;H.;Hiraumi;H.;Sakamoto;T.;Ito;J.;and Omori;K.
目的：使用移动的锥形束CT（mCBCT）评价人工耳蜗植入（CI）期间的电极状态。研究设计：回顾性病例回顾。设置：三级转诊医院。患者：57例（7例双侧手术，64耳）接受CI并接受术中mCBCT成像的患者。干预：术中CI和CBCT。主要结局指标：术中mCBCT图像确定的电极位置和角度插入深度。结果：有6例耳蜗畸形患者，术中mCBCT可用于确认电极位置。在耳蜗形态正常的58耳中，分别在30耳（耳蜗造口术; 14例先进的无探针技术病例）、27耳（26例圆窗[RW]插入，1例扩展圆窗[ERW]插入）和1耳（RW插入）中使用了蜗轴周电极、直电极和中标量电极。在35耳中实现了完整的鼓阶（ST）插入（耳蜗造口术14耳，RW或ERW插入21耳）。RW或ERW插入的完全ST插入率显著高于耳蜗造口术插入（p= 0.03），尽管使用先进的无探针技术的耳蜗造口术插入率与RW或ERW插入相似。环抱蜗轴电极的角度插入深度值（平均值±标准差）（354.4±29.44度）显著小于Flex24（464.8±43.09度）和Flex28（518.2±61.91度）电极（p< 0.05）。结论：使用术中mCBCT评价CI电极与使用扇形束CT或基于C形臂的CBCT评价CI电极具有可比性。考虑到mCBCT的低辐射剂量及其在任何手术室的可用性，mCBCT是评估人工耳蜗电极阵列的更好模式。
Objective:To evaluate the electrode status during cochlear implantation (CI) using mobile cone-beam CT (mCBCT).Study Design:Retrospective case review.Setting:Tertiary referral hospital.Patients:Fifty-seven patients (7 bilateral surgeries, 64 ears) who underwent CI and who received intraoperative mCBCT imaging.Intervention:CI and CBCT during surgery.Main Outcome Measure:Electrode location and angular insertion depth determined by intraoperative mCBCT images.Results:There were six cases with cochlear malformation where intraoperative mCBCT was useful to confirm electrode location. Of 58 ears with a normal cochlear morphology, perimodiolar, straight, and mid-scalar electrodes were used in 30 (cochleostomy; 14 advance off-stylet technique cases), 27 (26 round window [RW] insertion, 1 extended round window [ERW] insertion), and 1 (RW insertion) ears, respectively. Complete scala-tympani (ST) insertion was achieved in 35 ears (14 cochleostomy, 21 RW or ERW insertion). The complete ST-insertion rate was significantly higher with RW or ERW insertion than that for cochleostomy insertion (p= 0.03), although cochleostomy insertion using the advanced off-stylet technique had a similar rate to RW or ERW insertion. The angular insertion depth values (average±standard deviation) for perimodiolar electrodes (354.4±29.44 degrees) were significantly smaller than those for Flex24 (464.8±43.09 degrees) and Flex28 (518.2±61.91 degrees) electrodes (p< 0.05).Conclusions:Evaluation of CI electrodes using intraoperative mCBCT was comparable to that with fan-beam CT or c-arm-based CBCT. Considering the low radiation dose of mCBCT and its availability in any operation room, mCBCT is the better modality for evaluating cochlear implant electrode arrays.