Digital imaging: a valuable technique for the postoperative assessment of cochlear implantation

Abstract

Cochlear implantation with a multi-channel electrode array which provides stimulation via the auditory nerve has become a standard treatment for profound deafness. Postoperative radiography demonstrates electrode position and enables confirmation of satisfactory intra-cochlear electrode placement. The number of active electrodes which have been inserted can be determined and possible complications such as electrode kinking or slippage can be assessed. We evaluated digital radiography with confirmation of electrode position by intermittent fluoroscopy and assessed the relative radiation dose of the digital technique, conventional radiography and CT scanning. Radiation dose for this method usually ranges between 40 microGy and 440 microGy compared with a single exposure on the skull stand which produces a dose to the region of the cochlea of 470 microGy and a CT exposure of 950 microGy. The digital technique is comfortable for the patient, easily reproducible and provides images of high diagnostic quality enabling each electrode to be identified, which is especially valuable in association with postoperative electrode mapping. It also involves a lower radiation dose than conventional radiography. We now use digital radiography for all postoperative cochlear implant assessment.

Bionic ear imaging

“…A double examination was performed only on patients who were the first treated in our centre in order to establish the best technique to adopt. This was necessary given the lack of agreement in the literature regarding the relevant surgical procedures [18][19][20][21][22][23][24][25][26].…”

“…Sono stati sottoposti a doppia indagine solo i pazienti che per primi sono stati trattati presso questa struttura per poter stabilire quale fosse la migliore metodica da impiegare, necessità insorta in quanto si trattava di interventi chirurgici di cui non si poteva disporre di univoci dati in letteratura [18][19][20][21][22][23][24][25][26]. …”

Hybride 3D-Visualisierung und virtuelle Endoskopie von Cochlea-Implantaten

“…Die frühzeitige Kontrolle eines Cochlea-Implantats zur Dokumentation der korrekten intracochleären Lage der Stimulationselektrode ist wichtig, um gegebenenfalls eine Lagekorrektur durchführen zu können [6]. Deshalb wurde von mehreren Autoren die intraoperative Röntgenkontrolle empfohlen [9,10].…”

Pre-, Intra- and Post-Operative Imaging of Cochlear Implants

“…Until recently, plain radiography was the most commonly used post-operative imaging meth- Fig. 8a) [46]. Radiography is thus the method of choice in children [14].…”

“…This view is performed with the patient standing facing a vertical bucky, with neck flexed so that the orbito-meatal line is perpendicular to the table and then the head is rotated so that the mid-sagittal plane is approximately 45°to the film plane. The X-ray tube is angled in a way that the beam is approximately 12°cephalad to the orbito-meatal line [46]. Several other radiograhic techniques and modifications were suggested as alternatives for the Stenver's view including the "cochlear view" [51], and direct anteroposterior view [52].…”