ObjectivesThe aim of this study was to identify anatomical indication ranges for different lateral wall cochlear implant electrodes to support surgeons in the preoperative preparation.Methods272 patients who were implanted with a FLEX20, FLEX24, FLEX28, or a custom-made device (CMD) were included in this study. The cochlear duct length (CDL) and basal cochlear diameter (length A) were measured within preoperative imaging data. The parameter A was then employed to additionally compute CDL estimates using literature approaches. Moreover, the inserted electrode length (IEL) and insertion angle (IA) were measured in postoperative CT data. By combining the preoperative measurements with the IA data, the covered cochlea length (CCL) and relative cochlear coverage (CC) were determined for each cochlea.ResultsThe measurements of the CDL show comparable results to previous studies. While CDL measurements and estimations cover similar ranges overall, severe deviations occur in individual cases. The electrode specific IEL and CCL are fairly consistent and increase with longer electrodes, but relatively wide ranges of electrode specific CC values were found due to the additional dependence on the respective CDL. Using the correlation of IEL and CCL across electrode arrays, CDL ranges for selected arrays were developed (FLEX24: 31.3–34.4, FLEX28: 36.2–40.1, FLEXSoft: 40.6–44.9).ConclusionsOur analysis shows that electrode specific CC varies due to the CDL variation. Preoperative measurement of the CDL allows for an individualized implant length selection yielding optimized stimulation and a reduced risk of intraoperative trauma. The CDL, as derived from preoperative CT imaging studies, can help the implant surgeon select the appropriate electrode array to maximize the patient’s outcomes.
The proposed concept paves the way for holistic treatment strategy planning by enabling joint storing and processing of heterogeneous data from various information sources.
This new method appears to be useful for estimating spatial abilities in realistic multitalker scenes. The method is sensitive to the number of sources in the scene, and to effects of sensorineural hearing loss. Further work will be needed to compare this method to more traditional single-source localization tests.
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