Difficulty Of Insertion Research Articles

Overcoming difficulties in duodenoscope insertion due to scope deflection by mounting a splinting tube on a therapeutic video duodenoscope.

Asano and colleagues report their method of inserting a therapeutic video duodenoscope with the use of a splinting tube for challenging cases due to deformity of the pyloric antrum. With accompanying video, they demonstrate how this technique is promising for overcoming difficulties in duodenoscope insertion caused by scope deflection.

Coal-derived boron and phosphorus co-doped activated carbon with expanded interlayer space for high performance sodium ion capacitor anode

Aiming at the key problem of Na+ insertion difficulty and low charge transfer efficiency of activated carbon materials. It is an effective strategy to increase the lattice spacing and defect concentration by doping to reduce the ion diffusion resistance and improve the kinetics. Hence, anthracitic coal is used to prepare activated carbon (AC) and B,P-doped activated carbon (B,P-AC) as the cathode and anode materials for high-performance all-carbon SICs, respectively. AC cathode material has high specific surface area and reasonable micropore structure, which shows excellent capacitance performance. B,P-AC anode material has the advantages of extremely high specific surface area (1856.1 m2/g), expanded interlayer spacing (0.40 nm) and uniform distribution of B and P heteroatoms. Hence, B,P-AC anode achieves a highly reversible Na+ storage capacity of 243 mAh/g at a current density of 0.05 A/g. Density functional theory (DFT) calculations further verify that B,P-AC has stronger Na+ storage performance. The final assembled B,P-AC//AC SIC offers a high energy density of 109.78 Wh kg−1 and a high-power density of 10.03 kW kg−1. The high-performance coal-derived activated carbon of this work provides a variety of options for industrial production of electrode materials for sodium ion capacitors.

Versatile tissue‐injectable hydrogels capable of the extended hydrolytic release of bioactive protein therapeutics

AbstractHydrogels are extensively employed in healthcare due to their adaptable structures, high water content, and biocompatibility, with FDA‐approved applications ranging from spinal cord regeneration to local therapeutic delivery. However, clinical hydrogels encounter challenges related to inconsistent therapeutic exposure, unmodifiable release windows, and difficulties in subsurface polymer insertion. Addressing these issues, we engineered injectable, biocompatible hydrogels as a local therapeutic depot, utilizing poly(ethylene glycol) (PEG)‐based hydrogels functionalized with bioorthogonal SPAAC handles for network polymerization and functionalization. Our hydrogel solutions polymerize in situ in a temperature‐sensitive manner, persist in tissue, and facilitate the delivery of bioactive therapeutics in subsurface locations. Demonstrating the efficacy of our approach, recombinant anti‐CD47 monoclonal antibodies, when incorporated into subsurface‐injected hydrogel solutions, exhibited cytotoxic activity against infiltrative high‐grade glioma xenografts in the rodent brain. To enhance the gel's versatility, recombinant protein cargos can undergo site‐specific modification with hydrolysable “azidoester” adapters, allowing for user‐defined release profiles from the hydrogel. Hydrogel‐generated gradients of murine CXCL10, linked to intratumorally injected hydrogel solutions via azidoester linkers, resulted in significant recruitment of CD8+ T‐cells and the attenuation of tumor growth in a “cold” syngeneic melanoma model. This study highlights a highly customizable, hydrogel‐based delivery system for local protein therapeutic administration to meet diverse clinical needs.

Causes and countermeasures of difficulties in PICC insertion under ultrasound guidance

Causes and countermeasures of difficulties in PICC insertion under ultrasound guidance

(228) Would the Cylinders Lenght be Shorter in Men with Erectile Dysfunction After Prostatectomy or Peyronie's disease?

Abstract Introduction Inflatable penile prosthesis (IPP) is indicated to treatment for Erectile Dysfunction (ED). The men with erectile dysfunction, after prostatectomy and/or peyronie’s disease can affect penile atrophy. The three-volume IPP consists of a reservoir, pump, and cylinders. Penile atrophy could increase the difficulty of cylinders insertion or space. Would the cylinders length be shorter in men with erectile dysfunction after prostatectomy or Peyronie's disease? Objective We aimed to compare the cylinders length of IPP in three groups: patients with erectile dysfunction after prostatectomy, ED with Peyronie's disease AND ED only. Methods Retrospective study, single-center, included men with erectile dysfunction submitted to inflatable penile prosthesis. Divided into group 1 ED after prostatectomy, group 2 ED with Peyronie's and group 3 ED only. We performed a Kruskal-Wallis test to determine whether there were significant differences between three independent groups. To determine which groups have significant differences, we performed multiple comparisons using Dunn's test with Bonferroni correction for p-values. Results 136 patients were included in this analysis, Group 1 ED after prostatectomy (n=25), Group 2 ED with Peyronie's (n=29) and group 3 ED only (n=82). Age of patients were 64,08, 52,65 and 54,11, respectively. The minimum cylinders length used was 17.5cm and the maximum was 26cm. The Kruskal-Wallis test result was significant (p < 0.001), indicating that at least one is different from the others. Dunn's test results showed that the group 3 has a significantly higher median than the 1 and 2 groups (p < 0.001), while there was no significant difference between the groups 1 and 2 (p = 0.891). Conclusions Men with erectile dysfunction after prostatectomy and men with Peyronie's disease have a shorter total cylinder length when comparing erectile dysfunction only. These findings are important to guide patients regarding the expected results in the postoperative. Disclosure No.

Enhancing Safety in Automatic Electric Vehicle Charging: A Novel Collision Classification Approach

With the rise of electric vehicles, autonomous driving, and valet parking technologies, considerable research has been dedicated to automatic charging solutions. While the current focus lies on charging robot design and the visual positioning of charging ports, a notable gap exists in addressing safety aspects during the charging plug-in process. This study aims to bridge this gap by proposing a collision classification scheme for robot manipulators in automatic electric vehicle charging scenarios. In situations with minimal visual positioning deviation, robots employ impedance control for effective insertion. Significant deviations may lead to potential collisions with other vehicle parts, demanding discrimination through a global visual system. For moderate deviations, where a robot’s end-effector encounters difficulty in insertion, existing methods prove inadequate. To address this, we propose a novel data-driven collision classification method, utilizing vibration signals generated during collisions, integrating the robust light gradient boosting machine (LightGBM) algorithm. This approach effectively discerns the acceptability of collision contacts in scenarios involving moderate deviations. Considering the impact of passing vehicles introducing environmental noise, a noise suppression module is introduced into the proposed collision classification method, leveraging empirical mode decomposition (EMD) to enhance its robustness in noisy charging scenarios. This study significantly contributes to the safety of automatic charging processes, offering a practical and applicable collision classification solution tailored to diverse noisy scenarios and potential contact forms encountered by charging robots. The experimental results affirm the effectiveness of the collision classification method, integrating LightGBM and EMD, and highlight its promising prediction accuracy. These findings offer valuable perspectives to steer future research endeavors in the domain of autonomous charging systems.

Three-dimensional printed personalised digital guide plate for greater palatine block in trigeminal neuralgia

The nerve block is a safe and effective method to theat trigeminal neuralgia (TN). In terms of the V2 trigeminal neuralgia, the most difficult procedure in nerve block is accurate and fast greater palatine foramen (GPF) insertion. In this study, we developed a new technique using a personalised digital tooth-supported guide plate to increase insertion accuracy and success rates and reduce the pain of patients during injection. A total of 18 patients with TN (11 female and 7 male) were enrolled and treated between September 2020 and June 2022. Before injection, the guide plate was designed via Mimics three-dimensional (3D) reconstruction technology and printed via 3D printer. Then, all patients underwent maxillary nerve block with a guide plate for each injection. In this study, placement of all guide plates was completed within one minute and all punctures were successful the first time. The depth of the injection needle was over 2.5 cm in all cases and the guide plate was stability-supported by the maxillary teeth. The various pain scores had an obvious improvement. No patients presented symptoms of local anaesthetic toxicity or onset of new neurological sequelae. Using this new technology, we can significantly reduce the difficulty of GPF insertion and decrease patient pain during injection. The enhanced success rate of nerve block can achieve better therapeutic effect. For surgeons, personalised digital tooth-supported guide plates make the operation easier, especially for novice surgeons.

Complications in the use of peripherally inserted central catheter associated with peripheral intravenous therapy: retrospective cohort.

to analyze the occurrence of difficulty in the peripheral insertion of the central catheter and the presence of complications in the use of this device in hospitalized adults who received peripheral intravenous therapy through a short peripheral intravenous catheter and to identify whether there is an association between peripheral intravenous therapy and the presence of complications in the use of the peripherally inserted central catheter. retrospective cohort, with patients aged 18 years or over, in a tertiary teaching hospital, with a peripherally inserted central catheter, who had at least one previous short peripheral intravenous catheter. Data were analyzed using descriptive statistics and Poisson regression. the sample consisted of 76 patients. There was an association between difficulty in the insertion procedure and number of punctures (p<0.01) and insertion in the external jugular vein compared to the upper limbs (p<0.01). The insertion site was also associated with the removal of the peripherally inserted central catheter due to complications in the robust analysis of variance (p=0.02). No associations were identified between: difficulty inserting the device and time on peripheral intravenous therapy (crude model p=0.23; adjusted model p=0.21); difficulty in insertion with administration of irritating and vesicant medication (crude model p=0.69; adjusted model p=0.53); complication in the use of peripherally inserted central catheter and time of peripheral intravenous therapy (crude and adjusted models p=0.08); and secondary migration of the catheter tip with the device insertion site (p=0.24). it was possible to identify secondary migration as one of the main complications, resulting in premature removal of the device. Furthermore, the greater the number of puncture attempts to insert the PICC, the greater the difficulty in inserting it. Insertion into the external jugular vein was recurrent, with a higher risk of removal due to complications in relation to the upper limbs.

Investigation of the relationship between colonoscopy insertion difficulty factors and endoscope shape using an endoscopic position detection unit.

In this study, we investigated the relationship between the cecal intubation time (CIT) and the form and method used for passing through the sigmoid/descending colon junction (SDJ) and the hepatic flexure using an endoscopic position detection unit (UPD), with reference to various factors [age, sex, body mass index (BMI), history of abdominal and pelvic surgery, and diverticulum]. A total of 152 patients underwent colonoscopy with UPD. The mean age was 66.9 ± 12.4 years, and the male to female ratio was 3.6:1. The average CIT time was 14.3 ± 8.2 min. Age, number of experienced endoscopies, history of abdominal and pelvic surgery, BMI, and diverticulum were associated with prolonged CIT; SDJ passage pattern was straight: 8.6 ± 5.0, alpha loop: 11.8 ± 5.6, puzzle ring-like loop: 20.2 ± 5.0, reverse alpha loop: 22.4 ± 9.7, and other loop: 24.7 ± 10.5. The hepatic flexure passing method was in the following order: right rotation maneuver: 12.6 ± 6.6, push maneuver: 15.1 ± 5.9, and right rotation with positional change maneuver: 20.5 ± 7.2. In conclusion, colonoscopy with UPD revealed an association between CIT and SDJ passage pattern and hepatic flexure passing method.

Minimum education and training for pediatric and neonatal peripheral intravenous catheter care for all clinicians

Peripheral intravenous catheter (PIVC) insertion is a frequent procedure for hospitalized pediatric and neonatal patients. Timely and successful PIVC insertion can be challenging in pediatric and neonatal patients due to small or fragile veins, younger age, obesity, and patient activity (Alberto et al., 2023; Ben Abdelaziz et al., 2017; Girotto et al., 2020; Schults et al., 2019, 2022). First attempt insertion success ranges from 64% to 74%, with an average of 2.1 attempts prior to insertion of a functional PIVC (Kleidon et al., 2022). In children with difficult intravenous access (DIVA), the average number of attempts increases to four prior to an insertion of a functional PIVC (Kleidon et al., 2019; Schults et al., 2019). In addition to insertion difficulty, once a functional PIVC is successfully inserted, it is reported that 34% to 56% will fail prior to treatment completion, often necessitating the need for additional attempts to replace the failed PIVC (Indarwati et al., 2020; Kleidon et al, 2019; Kleidon, Rickard et al., 2020; van Rens, 2021).

Prevention of cuff injury of the intubation tube by blunt window opening in tracheostomy.

One of the intraoperative complications of tracheostomy under general anesthesia is cuff injury of the intubation tube. In the present study, we investigated whether a blunt tracheal opening is a useful method to avoid cuff injury. A retrospective cohort study was conducted to examine patients who underwent tracheostomy under general anesthesia at a single institution from January 1, 2017 to July 31, 2021. Electrocautery was used to thin the connective tissue between the tracheal rings, and bluntly open the trachea with mosquito forceps or similar instruments. Primary outcomes included cuff injury rate, number of surgeons involved, and career as otolaryngologist at the time of surgery. The secondary outcome was perioperative complications. Of the 64 cases, 3 had cuff injuries. 2 of the 3 had cuff injuries during the creation of an anteriorly based flap. 16 surgeons were involved ranging from the first to sixth year as an otolaryngologist, with the third year of otolaryngologist being the most common. The median physician year for instructors was 18 years. The most common postoperative complication was granulation in 9 cases. There were no cases of incorrect cannula insertion or difficulty in cannula insertion. A blunt tracheal opening was considered useful as a method to prevent cuff injury.

Use of Vein Finder to Overcome Factor Affecting Peripheral Intravenous Cannulation, Venipuncture, IV Insertion, and Blood Draws

To find a vein for intravenous insertion is quite difficult in most of the people. This difficulty is due to several factors, such as the demographic and clinical characteristics of the patients (age, sex, height, weight, ethnicity, IV drugs history, and medical history), health professional’s experience, device characteristics, site of insertion, and vein characteristics. Many insertion attempts has to be done due to difficulty in intravenous insertion. This makes the patient uncomfortable and frustrated leading to challenge for the health workers. It is also an expensive affair for the health institutions. Therfore to avoid the above problems medical practitioners should use the Vein Finder to locate the vein for intravenous insertion.

Assess the usage pattern of menstrual cups and its determinants among young health professionals at a tertiary hospital in Puducherry

: Menstrual cups are a better alternative for menstrual hygiene but usage among girls and women is limited due to lack of popularity. The purpose of this study is to assess the usage of menstrual cup and its determinants among young women in health profession.: This is a cross-sectional analytical study designed to collect data among 370 young women who fulfilled the selection criteria using a cluster sampling method. The objectives of the study were assessed with a self-administered questionnaire. The data were analyzed using descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics (chi-square). All statistical analysis was carried out at a 5% level of significance.: Among 370 young women only 29 (7.8%) use a menstrual cup, nearly 90% of them use it because it is comfortable, non-allergic, convenient during travel, and enables free movement. Only 8 (2.2%) have used it earlier but not presently, about 75% of them stopped because of difficulty in insertion. While 333 (90%) of young women have never used a menstrual cup, about 70% presumed menstrual cup insertion would be difficult and uncomfortable. : Young women despite being in the health profession and knowing about menstrual cups do not use them. This highlights the need for efforts to promote awareness regarding the availability and utilization of menstrual cups to empower girls and women in maintaining menstrual hygiene.

GlideScope versus C-MAC D-blade videolaryngoscope for double-lumen tube intubation in patients with anticipated difficult airways: A multi-center, prospective, randomized, controlled trial

Study objectiveVideolaryngoscopes are widely used to visualize difficult airways. Our aim was to compare the GlideScope and C-MAC D-blade videolaryngoscopes for double-lumen tube (DLT) intubation in patients with difficult airways. DesignA multi-center, prospective, randomized controlled trial. SettingThree comprehensive tertiary, high-volume hospitals from 5 December 2020 to 4 November 2021. PatientsWe included 348 adult patients with anticipated difficult airways who underwent elective thoracic surgery. InterventionsPatients were randomized into two groups: GlideScope and C-MAC D-blade. Following anesthesia induction, DLT intubation was performed using different videolaryngoscopes. MeasurementsThe primary outcome was the first-pass success rate of DLT intubation. All other results were recorded as secondary outcomes. Main resultsNo significant differences were observed in the first-pass success rate of DLT intubation between the GlideScope and C-MAC D-blade (86.21% and 89.66%, respectively; P = 0.323). However, compared with the GlideScope, the C-MAC D-blade provided a lower Cormack–Lehane grade (P < 0.001), lower rates of external laryngeal pressure (48 vs. 15, P < 0.001), and postprocedure sore throat (26 vs. 8, P < 0.001). The numerical rating score for difficulty of videolaryngoscope insertion into the oral cavity, delivery to the glottis, and intubation into the main bronchus were significantly lower when using the C-MAC D-blade (P < 0.001). Moreover, the duration of DLT intubation was shorter in the C-MAC D-blade group (81 s [70–97 s] vs. 95 s [78–115 s], P < 0.001). In each group, two patients underwent fiberoptic intubation after three attempts with a videolaryngoscope failed. ConclusionsIn patients with difficult airways, the GlideScope and C-MAC D-blade provided a similar success rate on the first DLT intubation attempt; however, the C-MAC D-blade offers a better glottic view, easier and faster intubation, and lower incidence of sore throat.

Computed tomography in measuring electrode insertion angle and depth for cricopharyngeal muscle electromyography.

Electromyography of the cricopharyngeal muscle (CP-EMG) is one of many assessment tools for dysphagia. The key to performing EMG and BTX injections is to precisely locate the cricopharyngeal muscle with an electrode. One of the main difficulties of electrode insertion is the fact that the CP muscle is located deep within the neck. Since a neck computed tomography (CT) can clearly display the CP muscle, thyroid, and blood vessels in the neck, we speculate that a safe concentric needle electrode insertion path to the cricopharyngeal muscle can be simulated with the assistance of the patient's neck CT which clearly marks the angle and depth of concentric needle electrode insertion. The purpose of this study was to explore simulated electrode insertion angles and insertion depths for cricopharyngeal electromyography based on retrospective CT data and present a method of percutaneous localization of the cricopharyngeal muscle based on CT images of the neck. One hundred and forty-three neck CT scans performed between January 2019 and November 2020 were included in this study. With the assistance of the angle and straight-line tools found in the Advantage Workstation 4.4 (GE, HealthCare), simulated insertion angles and depths from the anterior border of the sternocleidomastoid muscle to the cricopharyngeal muscle were obtained. The 143 CT images originated from participants that included 63 males (44.1%) with an average age of 46.2±13.9 years old. The insertion angle, insertion depth, and neck thickness measured on the CT images were 53.2±10.7˚, 24.2±4.1 mm, and 130.1±17.7 mm, respectively. The insertion angle and depth were significantly greater in males than in females (P<0.05), and the insertion angle increased with the age of participants (P<0.05). A generalized linear model (GLM) showed that insertion angle was positively correlated with neck thickness (β=0.14; 95% CI: 0.03 to 0.25) and gender (β=5.08; 95% CI: 1.31 to 8.85), and negatively correlated with age (β=-5.88; 95% CI: -9.54 to -1.62). Insertion depth was only positively correlated with the neck thickness (β=0.11; 95% CI: 0.07 to 0.15). This study indicates that age, gender, and neck thickness are influencing factors for insertion angle, while neck thickness is the influencing factor for insertion depth. The simulated concentric needle electrode insertion method based on CT can assist clinical operation to ensure safety and effectiveness of cricopharyngeal electromyography.

Assessment of two entry points for S2 alar-iliac screw in a Japanese cohort using three-dimensional computed tomography scan

Lumbosacral fusion supplemented with sacropelvic fusion has recently been increasingly employed for correcting spinal deformity and is associated with lower incidence of pseudarthrosis and implant failure. To date, few studies have evaluated anatomical parameters and technical feasibility between different entry points for S2 alar-iliac screws. To compare anatomical parameters and technical feasibility of two entry points for the S2 alar-iliac screw (S2AIS) in a Japanese cohort using three-dimensional (3D) computed tomography (CT). Retrospective cohort study. Fifteen men and 15 women aged 50-79 years who underwent pelvic CT at our hospital in 2013. Screw length, lateral angulation, caudal angulation, angle range, distance from the entry point to the sacroiliac joint, distance from the S2AIS to the acetabular roof, distance from the S2AIS to the sciatic notch, and insertion difficulty. We used 30 pelvic CT images (15 men and 15 women). We selected two entry points from previous studies: one was 1 mm distal and 1 mm lateral to the S1 dorsal foramen (A group) and the other was the midpoint between the S1 and S2 dorsal foramen (B group). We resliced the plane in which the pelvis was sectioned obliquely from these entry points to the anterior inferior iliac spine in the sagittal plane. We placed the shortest and longest virtual S2AISs bilaterally in this plane using a 4-mm margin. We measured screw length, lateral angulation, caudal angulation, angle range, distance from the entry point to the sacroiliac joint, distance from the S2AIS to the acetabular roof, distance from the S2AIS to the sciatic notch, and insertion difficulty. These measurements were compared between Groups A and B. In group A, the angle in the sagittal plane was significantly smaller and the distance from the entry point to the sciatic notch was significantly longer than in group B. Group B demonstrated a significantly longer screw length, longer distance from the entry point to the sacroiliac joint, and longer distance from the entry point to the acetabular roof than group A. The rate of insertion difficulty of S2AIS was much higher in group A. Insertion of S2AIS from the midpoint between the S1 and S2 dorsal foramen compared with the entry at distal and lateral to S1 foramen enables insertion of longer screws with low insertion difficulty.

Prosthodontic management of a partially edentulous patient with systemic sclerosis: A case report

Systemic sclerosis patients have restricted mouth opening along with narrowing of the oral aperture. This situation makes the clinical procedures associated with prosthodontic rehabilitation cumbersome and challenging. Manual dexterity of the patient is affected which could lead to poor oral hygiene maintenance as well as difficulty in insertion and removal of the removable prosthesis. This case report deliberates the difficulties in rehabilitating the partial edentulous state of an early diagnosed patient with systemic sclerosis.

Prevalence of Possible Dementia in Patients with Maxillofacial Defects and Difficulty of Inserting Obturator in Maxillectomy Patients: Toward Better Provision of Supportive Care.

As society ages, it is important to understand the prevalence of dementia and the difficulties of inserting prostheses in patients with maxillofacial defects in order to clarify issues in supportive care. We screened 183 patients for dementia using the revised Hasegawa's dementia scale (HDS-R) at the Clinic for Maxillofacial prosthetics, Tokyo Medical and Dental University, and investigated age and sex differences in HDS-R score. We asked 47 of the 183 participants about the difficulty of inserting a maxillofacial obturator prosthesis and collected subjective comments, information about the prosthesis, and data from five assessments. Multiple regression analysis was used to reveal factors associated with insertion difficulty. Overall, 8.7% of the participants were judged to have possible dementia. Men were more likely than women to have possible dementia, and the risk increased with age. Of the 47 participants, 26 reported difficulty inserting their prosthesis, 12 of whom attributed it to their oral defect. Fourteen patients advised following doctor's instructions to practice insertion in order to become accustomed to it. A lower HDS-R score had a significant impact on insertion difficulty. Cognitive function and difficulty inserting maxillary obturator prostheses should be considered in the provision of continuous supportive care to patients with maxillary defects.

Centrifuge tests and numerical simulations on vertical bearing capacity of mat foundation on marine clay seabed

Mat foundation is a new type of jack-up wind power installation platform suitable for clay seabed, which avoids the problems of excessive insertion and extraction difficulties of spudcan foundation on soft clay seabed. Evaluating the vertical bearing capacity of the mat foundation on the clay seabed is of great significance for the safe operation of jack-up platform in marine environment. In this research, the vertical bearing characteristics of mat foundation on horizontal and sloping clay seabed were studied through centrifuge tests. Then, numerical simulations were conducted to study the vertical bearing capacity of the full-scale mat foundation on clay seabed, in which the effects of the large mat foundation size, pile leg insertion depth, preloading, consolidation degree of soil, and soil plasticity were analyzed. The results show that the vertical bearing capacity of the mat foundations on the sloping seabed is reduced, and the soil under the mat foundation shows obvious sliding failure. The contribution of the insertion depth of pile legs on the horizontal bearing capacity is more obvious than that of the vertical bearing capacity. The enhancement of the vertical bearing capacity is mainly due to the dissipation of the excess pore pressure and the increase of the mean effective stress of the soil. The effects of preloading, consolidation degree, and soil property on the vertical bearing capacity of the mat foundation are significant.

Imaging Study &amp; Surgical Perspective Of Cochlear Implantees

Introduction: A cross-sectional prospective clinical study was done to evaluate the inner ear anomalies in candidates undergoing cochlear implantation. Materials and Methods: Study was carried out over a period of 07 years (Jan 2013 to Dec 2019) at Cochlear Implant Centre, Combined Military Hospital Dhaka. A total 206 deaf candidates, both pre and post lingual, were included in convenient sampling method. Result: The sample consisted of 206 candidates, of whom 117 (56.80%) were female and 89 (43.20%) were male. All candidates had severe to profound bilateral deafness. 182 (88.35%) of them were pre and 24 (11.65%) were in post lingual group. All patients diagnosed audiologically as profound deafness underwent HRCT scan of temporal bone with 3D reconstruction of cochlea and MRI of internal auditory canal &amp; brain. Radiological examination revealed that 36 (17.47%) candidates had ear anomalies. Mondini deformity 14 (06.80%), cochlear ossification 11 (5.34%), large vestibular aqueduct 04 (1.94%), high jugular bulb 04 (1.94%) and anteriorly placed sigmoid sinus 03 (1.45%) were noted. During intervention, 42 (20.39%) candidates had anomalous intra operative findings. Among them CSF gusher 19 (9.23%), ossification of basal turn 12 (5.83%), isolated rotated Cochlea 02 (0.97%), high jugular bulb 04 (1.94%), anteriorly placed sigmoid sinus 03 (1.45%), and very high facial nerve 02 (0.97%) were observed. During surgery, electrode insertion difficulty due to high CSF gusher was experienced in19 (9.23%) cases, full length of electrode insertion was not possible due to ossified basal turn 12 (5.83%), difficult to find out round window membrane due to rotated cochlea 02 (0.97%), prevented direct visualization of the round window due to high jugular bulb 04 (1.94%), difficult to approach round window due to very high facial nerve 02 (0.97%). and approach to round window membrane was compromised due to anteriorly placed sigmoid sinus 03 (1.45%). Most of these difficulties were effectively managed during surgery. Conclusions: This study highlights the importance of preoperative radiological scanning in the assessment of patients undergoing cochlear implantation. It provides vital information on cochlear status and in ruling out non cochlear causes where cochlear implantation is not feasible. Detection of anatomical abnormalities with appropriate evaluation, specially imaging should be mandatory in every patient undergoing cochlear implantation. J Dhaka Med Coll. 2021; 30(2) : 167-175