Evaluating temporal bone column density for optimized bone conduction implant placement

Talon, Emile; Wagner, Franca; Weder, Stefan; Anschuetz, Lukas; Caversaccio, Marco; Wimmer, Wilhelm

doi:10.3389/fsurg.2023.1293616

Cited by 2 publications

(1 citation statement)

References 55 publications

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“…The recess model can easily be changed to fit alternative parameters of the ROI, the CI model used, and the recess dimensions. Although the algorithm was designed for thickness feasibility measurement of a R/S device recess, the methodology used in the study could also be applied for other implantable device for which a bone thickness analysis would beneficial ( 22 – 24 ). Furthermore, the time required to perform the analysis is minimal thanks to the limited manual input needed, providing physicians readily available results.…”

Section: Discussionmentioning

confidence: 99%

Cochlear implant positioning: development and validation of an automatic method using computed tomography image analysis

Kemper,

Markodimitraki,

Magré

et al. 2024

Front. Surg.

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The aim of this study was to preoperatively asses the feasibility of drilling a bony recess for the fixation of a cochlear implant in the temporal bone. Even though complications are rare with cochlear implantations, drilling at the site of implantation have resulted in hematoma or cerebrospinal fluid leakage. Mainly in cases with a reduced temporal bone thickness, the risk for complications has increased, such as in paediatric patients.MethodsAn in-house designed semi-automatic algorithm was developed to analyse a 3D model of the skull. The feasibility of drilling the recess was determined by a gradient descent method to search for the thickest part of the temporal bone. Feasibility was determined by the residual bone thickness which was calculated after a simulated drilling of the recess at the thickest position. An initial validation of the algorithm was performed by measuring the accuracy of the algorithm on five 3D models with known thickest locations for the recess. The accuracy was determined by a part comparison between the known position and algorithm provided position.ResultsIn four of the five validation models a standard deviation for accuracy below the predetermined cut-off value of 4.2 mm was achieved between the actual thickest position and the position determined by the algorithm. Furthermore, the residual thickness calculated by the algorithm showed a high agreement (max. 0.02 mm difference) with the actual thickness.ConclusionWith the developed algorithm, a semi-automatic method was created to analyse the temporal bone thickness within a specified region of interest on the skull. Thereby, providing indications for surgical feasibility, potential risks for anatomical structures and impact on procedure time of cochlear implantation. This method could be a valuable research tool to objectively assess feasibility of drilling a recess in patients with thin temporal bones preoperatively.

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Section: Discussionmentioning

confidence: 99%

Cochlear implant positioning: development and validation of an automatic method using computed tomography image analysis

Kemper,

Markodimitraki,

Magré

et al. 2024

Front. Surg.

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Resonance Frequency Analysis Identifies Implant- and Host-Related Factors Associated With Bone-Anchored Hearing Implant Stability

Bezdjian,

Mikolajewicz,

Denton

et al. 2024

Otol Neurotol

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Hypothesis Resonance frequency analysis (RFA) is a reliable, noninvasive method to assess the stability of bone-anchored hearing implants (BAHIs), although surgical-, implant-, and host-related factors can affect its outcome. Background BAHI plays an important role in restoring hearing function. However, implant- and host-related factors contribute to premature implant extrusion. To mitigate this, noninvasive methods to assess implant stability, along with a better understanding of factors contributing to BAHI failure, are needed. Methods We evaluated the utility of RFA to quantify implant stability in sawbone (bone mimicking material), 29 human cadaveric samples, and a prospective cohort of 29 pediatric and 27 adult participants, and identified factors associated with implant stability. To validate the use of RFA in BAHI, we compared RFA-derived implant stability quotient (ISQ) estimates to peak loads obtained from mechanical push-out testing. Results ISQ and peak loads were significantly correlated (Spearman rho = 0.48, p = 0.0088), and ISQ reliably predicted peak load up to 1 kN. We then showed that in cadaveric samples, abutment length, internal table bone volume, and donor age were significantly associated with implant stability. We validated findings in our prospective patient cohort and showed that minimally invasive Ponto surgery (MIPS; versus linear incision), longer implantation durations (>16 wk), older age (>25 yr), and shorter abutment lengths (≤10 mm) were associated with better implant stability. Finally, we characterized the short-term reproducibility of ISQ measurements in sawbone and patient implants. Conclusions Together, our findings support the use of ISQ as a measure of implant stability and emphasize important considerations that impact implant stability, including surgical method, implant duration, age, and abutment lengths.

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Evaluating temporal bone column density for optimized bone conduction implant placement

Cited by 2 publications

References 55 publications

Cochlear implant positioning: development and validation of an automatic method using computed tomography image analysis

Cochlear implant positioning: development and validation of an automatic method using computed tomography image analysis

Resonance Frequency Analysis Identifies Implant- and Host-Related Factors Associated With Bone-Anchored Hearing Implant Stability

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