PubMed · 13048218
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R MAYOUX, H MARTIN. [Cochlear functional synergy].. https://pubmed.ncbi.nlm.nih.gov/13048218/
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Three methods of determining electrode insertion depth in cochlear implantees are studied: intraoperative counting of inserted electrodes, plain film radiography using Stenvers projection and postoperative electrode function testing. In 16 cases the number of electrodes inserted in the cochlea were counted both by the surgeon at surgery and by two independent observers on plain film radiographs using Stenvers projections. The electrode function was tested postoperatively. The differences between the three methods in estimation of the number of intracochlear electrodes were analyzed with t-tests, and 95% confidence intervals (95% CI) of the mean differences were calculated. The mean difference between the radiograph observers was 0.25 electrode (95% CI, -0.69 to 1.19 electrodes.) The mean difference between radiography observations and the surgical counts was 0.60 electrode (95% CI, -0.71 to 1.91 electrodes.) The mean difference between surgical counting and electrode function testing was 0.40 electrode (95% CI, -0.66 to 1.46 electrodes.) The mean difference between radiograph observations and electrode function testing was 0.50 electrode (95% CI, -0.51 to 1.51 electrodes.) No significant differences existed between the three methods. Our findings showed similar results in estimating electrode array insertion depth with the three methods. Plain film radiography using Stenvers projection is satisfactory if imaging is indicated for determining the number of inserted electrodes.
Cochlear implant (CI) is an electronic device used to rehabilitate patients with sensorineural hearing loss. The intent of this review is to demonstrate the normal position of the electrode on computed tomography (CT) and contrast this with various examples of the electrode malpositioning. Post-implantation CT is performed to localize the cause of implant failure in patients in which radiographs suggest an anomalous course of the electrode. A common cause of device failure is extrusion or malpositioning of the electrode. It is important for the radiologists to recognize this important aspect of device failure. Post-implant CT can help identify patients with malpositioned electrode in whom another attempt can be made by correctly re-implanting the electrode.
This pictorial review describes the application of high-resolution computed tomography to the investigation and pre-operative work-up of the common lesions of congenital hearing loss, including congenital aural dysplasia, various congenital ossicular anomalies, inner ear dysmorphology, large vestibular aqueduct syndrome, and congenital absence of cochlear nerve and labyrinthitis ossificans from previous infection. The aim is to help radiologists to provide a more accurate diagnosis of underlying aetiology and assist in surgical planning.