Abstract
Conclusions: The present experimental set-up of high spatial resolution cone-beam computed tomography (CBCT) showed advantages of demonstrating the critical landmarks of the cochlea in identifying the position of intracochlear electrode contacts and has the potential for clinical application in cochlear implant (CI) surgery. Objective: To evaluate a newly developed CBCT system in defining CI electrode array in human temporal bone and cochlear morphological variation. Methods: Standard electrode, flexible tip electrode (Flex28), and an experimental electrode array with 36 contacts from MED-EL were implanted into the cochleae of six human temporal bones through an atraumatic round window membrane insertion. The cochleae were imaged with 900 frames using an experimental set-up based on a CBCT scanner installed with Superior SXR 130-15-0.5 X-ray tube in combination with filtration of copper and aluminum. Results: In all temporal bones, the landmarks of the cochlea, modiolus, osseous spiral lamina, round window niche, and stapes were demonstrated at an average level of 3.4–4.5. The contacts of electrode arrays were clearly shown to locate in the scala tympani. There was a linear correlation between the ‘A’ value and cochlea height, and between the A value and actual electrode insertion length for the first 360° insertion depth.
Highlights
Cone-beam computed tomography (CBCT) is going to play a key role in cochlear implantation, which provides functional restoration of hearing in individuals with profound hearing impairment, in both planning the implantation before surgery and quality control during the surgery
cone-beam computed tomography (CBCT) has the advantage over multi-detector CT (MDCT) of fast data acquisition, which is less than a minute versus several minutes for MDCT, low-dose exposure of the subject, small metallic artefact, and a relatively low equipment purchase price
In all temporal bones imaged with the present experimental set-up, the landmarks of the cochlea, modiolus, osseous spiral lamina, round window niche, and stapes were demonstrated at an average level of 3.4–4.5 (Table II)
Summary
Cone-beam computed tomography (CBCT) is going to play a key role in cochlear implantation, which provides functional restoration of hearing in individuals with profound hearing impairment, in both planning the implantation (selection of electrode model and designing the surgical procedure) before surgery and quality control (confirmation of electrode array position accurately in the cochlear scala) during the surgery. Gupta et al in 2004 reported an experimental flatpanel high-spatial resolution volume CT for temporal bone imaging using a smaller detector element and acquired a total of 900 cone-beam projections under (Received 20 October 2014; accepted 17 November 2014).
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