Electrode Position Research Articles

Intraoperative 3D fluoroscopy accurately predicts final electrode position in deep brain stimulation surgery

PurposeIn the absence of an intraoperative CT or MRI setup, post-implantation confirmation of electrode position in deep brain stimulation (DBS) requires patient transportation to the radiology unit, prolonging surgery time. This project aims to validate intraoperative 3D fluoroscopy (3DF), a widely available tool in Neurosurgical units, as a method to determine final electrode position.MethodsWe performed a retrospective study including 64 patients (124 electrodes) who underwent DBS at our institution. Intraoperative 3DF after electrode implantation and postoperative volumetric CT were acquired. The Euclidean coordinates of the electrode tip displayed in both imaging modalities were determined and inter-method deviations were assessed. Pneumocephalus was quantified and its potential impact in determining the electrode position analyzed. Finally, 3DF and CT-imposed exposure to radiation was compared.ResultsThe difference between the electrode tip estimated by 3DF and CT was 0.85 ± 0.03 mm, and not significantly different (p = 0.11 for the distance to MCP assessed by both methods), but was, instead, highly correlated (p = 0.91; p < 0.0001). Even though pneumocephalus was larger in 3DF (6.89 ± 1.76 vs 5.18 ± 1.37 mm3 in the CT group, p < 0.001), it was not correlated with the difference in electrode position measured by both techniques (p = 0.17; p = 0.06). Radiation exposure from 3DF is significantly lower than CT (0.36 ± 0.03 vs 2.08 ± 0.05 mSv; p < 0.0001).ConclusionsIntraoperative 3DF is comparable to CT in determining the final DBS electrode position. Being a method with fewer radiation exposure, less expensive, faster and that avoids patient transportation outside the operation room, it is a valid tool to replace postoperative CT.

Optimizing Transcutaneous Spinal Stimulation: Excitability of Evoked Spinal Reflexes is Dependent on Electrode Montage.

There is growing interest in use of transcutaneous spinal stimulation (TSS) for people with neurologic conditions both to augment volitional control (by facilitating motoneuron excitability), and to decrease spasticity (by activating inhibitory networks). Various electrode montages are used during TSS, with little understanding of how electrode position influences spinal circuit activation. We sought to identify the thoracolumbar electrode montage associated with the most robust activation of spinal circuits by comparing posterior root-muscle reflexes (PRM reflexes) elicited by 6 montages. Additionally, we assessed tolerability of the stimulation during PRM reflex testing. Fifteen adults with intact neurological systems participated in this randomized crossover study. PRM reflexes were evoked transcutaneously using electrode montages with dorsal-ventral (DV) or dorsal-midline (DM) current flow. DV montages included: [1] cathode over T11/T12, anodes over iliac crests (DV-I), [2] cathode over T11/T12, anodes over umbilicus (DV-U), [3] dual paraspinal cathodes at T11/12, anodes over iliac crests (DV-PI), and [4] dual paraspinal cathodes at T11/12, anodes over umbilicus (DV-PU). DM montages included: [5] cathode over T11/12, anode 5cm caudal (DM-C), and [6] cathode over T11/12, anode 5cm rostral (DM-R). PRM reflex recruitment curves were obtained in the soleus muscle of both lower extremities. DV-U and DV-I montages elicited bilateral reflexes with lower reflex thresholds and larger recruitment curve area than other montages. There were no differences in response amplitude at 120% of RT(1.2xRT) or tolerability among montages. Differences in spinal circuit recruitment are reflected in the response amplitude of the PRM reflexes. DV-I and DV-U montages were associated with lower reflex thresholds, indicating that motor responses can be evoked with lower stimulation intensity. DV-I and DV-U montages therefore have the potential for lower and more tolerable interventional stimulation intensities. Our findings optimize electrode placement for interventional TSS and PRM reflex assessments.

Performance optimization of an air-assisted electrostatic spraying unit using response surface methodology

An air-assisted electrostatic spraying unit along with a set-up to measure the spray current was developed. Response surface methodology was used to optimize the performance of the developed electrostatic spraying unit. The optimum parameters such as electrode diameter, electrode voltage, electrode position and target distance for maximizing charge-to-mass ratio (CMR) were determined to be 30 mm, 2000 V, 0 mm and 400 mm, respectively Predicted CMR under optimal conditions was experimentally validated. Furthermore, charged spray demonstrated 1.5 to 4.6 times higher droplet deposition with lower uniformity coefficient (2.13–2.14) and relative span factor (0.84–0.9) compared to uncharged spray.

Development and numerical optimization of a cylindrical wire-fin-type integrated ionic wind heat sink for cooling high-power LEDs

Light-emitting diodes (LEDs) are becoming increasingly high-power and compact, which makes rotary fans incompetent in some cooling situations. The ionic wind technique can compensate for the shortcomings of rotating fans, owing to its benefits of no moving parts and compact structure. Integrating the ionic wind generator with heat dissipation fins can effectively reduce the size of LED devices, but research in this area is still insufficient. In this study, an integrated ionic wind heat sink is designed for cooling LEDs. The multi-physical characteristics of discharge, flow, and heat transfer are numerically studied. The geometric parameters’ impact degree and mechanism on the multi-physical characteristics are analyzed. The performance optimization of the integrated heat sink is realized and verified. The fin length, flow channel center angle, and relative position of the fin have a large influence on the average velocity of ionic wind. The relative position of the wire electrode determines the electric field strength distribution, and it has the greatest influence on the ionic wind performance. The emitting electrode being placed at the inlet edge of the collecting electrode produces a high ionic wind flow rate. The integrated ionic wind heat sink designed in this study exhibits an outstanding cooling performance and temperature uniformity. This device can cool down the surface of a heat source with a power of 200 W to below 91 °C and make the average heat transfer coefficient reach 18.6 W/(m2·K). This study proposes a valuable method to optimize the integrated ionic wind heat sink for cooling high-power electronic devices.

NeuroRoots, a bio-inspired, seamless brain machine interface for long-term recording in delicate brain regions.

Scalable electronic brain implants with long-term stability and low biological perturbation are crucial technologies for high-quality brain-machine interfaces that can seamlessly access delicate and hard-to-reach regions of the brain. Here, we created "NeuroRoots," a biomimetic multi-channel implant with similar dimensions (7 μm wide and 1.5 μm thick), mechanical compliance, and spatial distribution as axons in the brain. Unlike planar shank implants, these devices consist of a number of individual electrode "roots," each tendril independent from the other. A simple microscale delivery approach based on commercially available apparatus minimally perturbs existing neural architectures during surgery. NeuroRoots enables high density single unit recording from the cerebellum in vitro and in vivo. NeuroRoots also reliably recorded action potentials in various brain regions for at least 7 weeks during behavioral experiments in freely-moving rats, without adjustment of electrode position. This minimally invasive axon-like implant design is an important step toward improving the integration and stability of brain-machine interfacing.

Detection of early neurological deterioration using a quantitative electroencephalography system in patients with large vessel occlusion stroke after endovascular treatment

BackgroundEarly neurological deterioration (END) is a serious complication in patients with large vessel occlusion (LVO) stroke. However, modalities to monitor neurological function after endovascular treatment (EVT) are lacking. This study...

Intraoperative microelectrode recording during asleep deep brain stimulation of subthalamic nucleus for Parkinson Disease. A case series with systematic review of the literature

The use of microelectrode recording (MER) during deep brain stimulation (DBS) for Parkinson Disease is controversial. Furthermore, in asleep DBS anesthesia can impair the ability to record single-cell electric activity.The purpose of this study was to describe our surgical and anesthesiologic protocol for MER assessment during asleep subthalamic nucleus (STN) DBS and to put our findings in the context of a systematic review of the literature. Sixty-three STN electrodes were implanted in 32 patients under general anesthesia. A frameless technique using O-Arm scanning was adopted in all cases. Total intravenous anesthesia, monitored with bispectral index, was administered using a target controlled infusion of both propofol and remifentanil. A systematic review of the literature with metanalysis on MER in asleep vs awake STN DBS for Parkinson Disease was performed. In our series, MER could be reliably recorded in all cases, impacting profoundly on electrode positioning: the final position was located within 2 mm from the planned target only in 42.9% cases. Depth modification > 2 mm was necessary in 21 cases (33.3%), while in 15 cases (23.8%) a different track was used. At 1-year follow-up we observed a significant reduction in LEDD, UPDRS Part III score off-medications, and UPDRS Part III score on medications, as compared to baseline. The systematic review of the literature yielded 23 papers; adding the cases here reported, overall 1258 asleep DBS cases using MER are described. This technique was safe and effective: metanalysis showed similar, if not better, outcome of asleep vs awake patients operated using MER. MER are a useful and reliable tool during asleep STN DBS, leading to a fine tuning of electrode position in the majority of cases. Collaboration between neurosurgeon, neurophysiologist and neuroanesthesiologist is crucial, since slight modifications of sedation level can impact profoundly on MER reliability.

Intra-Cochlear Electrode Position Impacts the Preservation of Residual Hearing in an Animal Model of Cochlear Implant Surgery.

Preservation of residual hearing after cochlear implantation remains challenging. There are several approaches to preserve residual hearing, but the configuration of the implant electrode array seems to play a major role. Lateral wall electrode arrays are seemingly more favorable in this context. To date, there are no experimental data available which correlate the spatial electrode position in the scala tympani with the extent of hearing preservation. Based on micro-computed tomography (µCT) imaging data, this study analyses the exact position of a pure silicone electrode array inserted into the cochlea of four guinea pigs. Array position data were correlated with the extent of hearing loss after implantation, measured using auditory brainstem measurements in the frequency range of the area occupied by the electrode array area as well as apical to the array. The use of pure silicone arrays without electrodes resulted in artifact-free, high-resolution µCT images that allowed precise determination of the arrays' positions within the scala tympani. The electrode arrays' locations ranged from peri-modiolar to an anti-modiolar. These revealed a correlation of a lower postoperative hearing loss with a higher spatial proximity to the lateral wall. This correlation was found in the low-frequency range only. A significant correlation between the inter-individual differences in the diameter of the scala tympani and the postoperative hearing loss could not be observed. This study demonstrates the importance of the intra-cochlear electrode array's position for the preservation of residual hearing. The advantage of such an electrode array's position approximated to the lateral wall suggests, at least for this type of electrode array applied in the guinea pig, it would be advantageous in the preservation of residual hearing for the apical part of the cochlea, beyond the area occupied by the electrode array.

Electroconvulsive Therapy and Akathisia: A Comprehensive Literature Review of Case Reports.

This review aimed to investigate the effects of electroconvulsive therapy (ECT) on akathisia. We systematically searched MEDLINE and Embase and included case reports on akathisia caused by or treated with ECT. We identified and included 9 articles. Seven articles, representing 10 cases, reported that akathisia improved after ECT. Most cases (7 cases) were diagnosed with a mood disorder, and all 10 cases were treated with antipsychotics. Akathisia was regarded as tardive (3 cases) and severe (4 cases). Although treatments for akathisia, such as adjusting antipsychotics and adding medication for akathisia, were tried before ECT, ultimately none were effective. In all 10 cases, akathisia showed significant improvement after ECT, and nonantipsychotic psychotropics or low-dose antipsychotics were administered as post-ECT treatment. Two articles (5 cases) reported that akathisia occurred after ECT. Three of these cases were diagnosed with a mood disorder, and all 5 cases were treated with perphenazine and tricyclic antidepressants. Akathisia occurred multiple times after ECT, but it was transient. Despite attempts to manage the akathisia, including discontinuation of psychotropics, addition of medication for akathisia, and adjustment of stimulation electrode positions, the outcomes of the interventions were inconsistent. Nonetheless, no persistent akathisia was observed after the end of the ECT course. Although the effects of ECT on akathisia remain unclear because of the paucity of high-quality studies, ECT could be considered particularly for treatment-resistant, tardive, and/or severe akathisia comorbid with mood disorders. Conversely, clinicians should keep in mind that transient akathisia can develop following ECT.

Fabrication and Dielectric Validation of an Arm Phantom for Electromyostimulation.

Electromyostimulation (EMS) is an up-and-coming training method that demands further fundamental research regarding its safety and efficacy. To investigate the influence of different stimulation parameters, electrode positions and electrode sizes on the resulting voltage in the tissue, a tissue mimicking phantom is needed. Therefore, this study describes the fabrication of a hydrogel arm phantom for EMS applications with the tissue layers of skin, fat, blood and muscle. The phantom was dielectrically validated in the frequency range of 20 Hz to 100 Hz. We also conducted electromyography (EMG) recordings during EMS on the phantom and compared them with the same measurements on a human arm. The phantom reproduces the dielectric properties of the tissues with deviations ranging from 0.8% to more than 100%. Although we found it difficult to find a compromise between mimicking the permittivity and electrical conductivity at the same time, the EMS-EMG measurements showed similar waveforms (1.9-9.5% deviation) in the phantom and human. Our research contributes to the field of dielectric tissue phantoms, as it proposes a multilayer arm phantom for EMS applications. Consequently, the phantom can be used for initial EMS investigations, but future research should focus on further improving the dielectric properties.

Electrocochleography in Cochlear Implant Recipients: Correlating Maximum Response With Residual Hearing.

Electrocochleography (ECochG) is increasingly recognized as a biomarker for assessing inner ear function in cochlear implant patients. This study aimed to objectively determine intraoperative cochlear microphonic (CM) amplitude patterns and correlate them with residual hearing in cochlear implant recipients, addressing the limitations in current ECochG analysis that often depends on subjective visual assessment and overlook the intracochlear measurement location. In this prospective study, we investigated intraoperative pure-tone ECochG following complete electrode insertion in 31 patients. We used our previously published objective analysis method to determine the maximum CM amplitude and the associated electrode position for each electrode array. Using computed tomography, we identified electrode placement and determined the corresponding tonotopic frequency using Greenwood's function. Based on this, we calculated the tonotopic shift, that is, the difference between the stimulation frequency and the estimated frequency of the electrode with the maximum CM amplitude. We evaluated the association between CM amplitude, tonotopic shift, and preoperative hearing thresholds using linear regression analysis. CM amplitudes showed high variance, with values ranging from -1.479 to 4.495 dBµV. We found a statistically significant negative correlation () between maximum CM amplitudes and preoperative hearing thresholds. In addition, a significant association () between the tonotopic shift and preoperative hearing thresholds was observed. Tonotopic shifts of the maximum CM amplitudes occurred predominantly toward the basal direction. The combination of objective signal analysis and the consideration of intracochlear measurement locations enhances the understanding of cochlear health and overcomes the obstacles of current ECochG analysis. We could show the link between intraoperative CM amplitudes, their spatial distributions, and preoperative hearing thresholds. Consequently, our findings enable automated analysis and bear the potential to enhance specificity of ECochG, reinforcing its role as an objective biomarker for cochlear health.

Automatic localization of cochlear implant electrodes using cone beam computed tomography images

BackgroundCochlear implants (CI) are implantable medical devices that enable the perception of sounds and the understanding of speech by electrically stimulating the auditory nerve in case of inner ear damage. The stimulation takes place via an array of electrodes surgically inserted in the cochlea. After CI implantation, cone beam computed tomography (CBCT) is used to evaluate the position of the electrodes. Moreover, CBCT is used in research studies to investigate the relationship between the position of the electrodes and the hearing outcome of CI user. In clinical routine, the estimation of the position of the CI electrodes is done manually, which is very time-consuming.ResultsThe aim of this study was to optimize procedures of automatic electrode localization from CBCT data following CI implantation. For this, we analyzed the performance of automatic electrode localization for 150 CBCT data sets of 10 different types of electrode arrays. Our own implementation of the method by Noble and Dawant (Lecture notes in computer science (Including subseries lecture notes in artificial intelligence and lecture notes in bioinformatics), Springer, pp 152–159, 2015. https://doi.org/10.1007/978-3-319-24571-3_19) for automated electrode localization served as a benchmark for evaluation. Differences in the detection rate and the localization accuracy across types of electrode arrays were evaluated and errors were classified. Based on this analysis, we developed a strategy to optimize procedures of automatic electrode localization. It was shown that particularly distantly spaced electrodes in combination with a deep insertion can lead to apical–basal confusions in the localization procedure. This confusion prevents electrodes from being detected or assigned correctly, leading to a deterioration in localization accuracy.ConclusionsWe propose an extended cost function for automatic electrode localization methods that prevents double detection of electrodes to avoid apical–basal confusions. This significantly increased the detection rate by 11.15 percent points and improved the overall localization accuracy by 0.53 mm (1.75 voxels). In comparison to other methods, our proposed cost function does not require any prior knowledge about the individual cochlea anatomy.

Effect of dispersive electrode position (anterior vs. posterior) in epicardial radiofrequency ablation of ventricular wall: A computer simulation study.

An epicardial approach is often used in radiofrequency (RF) catheter ablation to ablate ventricular tachycardia when an endocardial approach fails. Our objective was to analyze the effect of the position of the dispersive patch (DP) on lesion size using computer modeling during epicardial approach. We compared the posterior position (patient's back), commonly used in clinical practice, to the anterior position (patient's chest). The model considered ventricular wall thicknesses between 4 and 8 mm, and electrode insertion depths between .3 and .7 mm. RF pulses were simulated with 20 W of power for 30 s duration. Statistically significant differences (P < .001) were found between both DP positions in terms of baseline impedance, RF current (at 15 s) and thermal lesion size. The anterior position involved lower impedance (130.8 ± 4.7 vs. 146.2 ± 4.9 Ω) and a higher current (401.5 ± 5.6 vs. 377.5 ± 5.1 mA). The anterior position created lesion sizes larger than the posterior position: 8.9 ± 0.4 vs. 8.4 ± 0.4 mm in maximum width, 8.6 ± 0.4 vs. 8.1 ± 0.4 mm in surface width, and 4.5 ± 0.4 vs. 4.3 ± 0.4 mm in depth. Our results suggest that: (1) the redirection of the RF currents due to repositioning the PD has little impact on lesion size and only affects baseline impedance, and (2) the differences in lesion size are only 0.5 mm wider and 0.2 mm deeper for the anterior position, which does not seem to have a clinical impact in the context of VT ablation.

Functional characteristics and storage stability of hot air assisted radio frequency treated pearl millet

Nutricereals, pearl millet flour consumption is hardly limited to a few specific regions of the world owing to the development of early rancidity on storage. Hot air assisted radio frequency technology (HARF) was used to improve the storage stability of pearl millet flour. Pearl millets at different moisture levels of 10.5±0.5, 12 & 15% were subjected to HARF for 5-, 10- & 15-min exposure period under fixed electrode position. The results revealed that significant reduction in peroxide value and free fatty acid values of flours from treated pearl millet was found compared to decorticated raw flour; thereby, the storage stability enhancement of pearl millet flour up to 180 days was achieved. No significant difference was found for emulsifying, foaming and cooking properties between treated pearl millet at 15% moisture, 15 min exposure and decorticated raw one. In contrast, the bulk density of flour from treated pearl millet was found higher. Significant increase in hardness of cooked grains after the treatment was observed while the springiness, cohesiveness and gumminess values did not vary. In FTIR analysis, no difference was observed between the peaks of whole and decorticated pearl millet flours in both untreated and treated samples.Graphical

Carbon dot enhanced electrodeposited coatings for advanced early-stage corrosion sensing

This work explores a novel approach for metal corrosion by integrating carbon dots (CDs) into electrodeposited (ED) coatings. We detail the synthesis and properties of CDs, making them suitable for corrosion detection. Characterization techniques like Fourier Transform Infrared Spectroscopy (FTIR), Scanning electron microscope (SEM), Energy Dispersive X-ray Analysis (EDX), Fluorescent Microscopy and Photoluminescence Spectroscopy (PL).A Design of Experiment (DOE) optimized parameters like CD concentration, curing temperature, and voltage for improved coating performance. The optimized conditions (0.4 wt% M-CDots, 165 °C curing, and 36.2 V) resulted in enhanced adhesion and corrosion resistance.CD-infused coatings demonstrated superior adhesion and mechanical stability compared to controls. Electrochemical tests confirmed a 10 % improvement in corrosion resistance and PL study demonstrated an approximately 60 % enhancement in emission intensity. The adhesion was not affected by introducing carbon dots to the coating. Monitoring the onset of metal corrosion on samples in salt spray cabinets was achieved through the use of a UV source. The photoluminescence of M-CDs offered real-time, non-destructive monitoring of early-stage corrosion through quenching in the presence of exposed metal surfaces.This research presents a significant advancement by integrating CD-based sensing into corrosion-resistant coatings, holding promise for various industries and leading to improved safety, reduced maintenance costs, and extended equipment lifespans. Notably, the biocompatible and disposable nature of CD-based sensors further enhances their practical application.

Utilization of SmartNav technology in cochlear implantation: optimizing efficiency in assessment of electrode placement

Objectives Proper electrode placement is essential for favorable hearing outcomes following cochlear implantation. Though often used, traditional intraoperative X-ray imaging is time consuming, exposes patients and staff to radiation, and poses interpretational challenges. The Nucleus® SmartNav System, utilizes electrode voltage telemetry (EVT) to analyze the positioning of the electrode array intraoperatively. This study investigates the efficacy of SmartNav in optimizing the efficiency and accuracy of assessing electrode placement. Methods This prospective clinical study analyzed placement of 50 consecutive Cochlear Corporation cochlear implants conducted at a single institution between March of 2022 and June of 2023. Placement check of electrode array using SmartNav and X-ray was completed and individually assessed. A comparative analysis of SmartNav and X-ray completion times for electrode placement assessment was conducted. Results Subjects included nine ears with abnormal anatomy and three reimplants. SmartNav placement check required a total time of 2.12 min compared to X-ray imaging at 14.23 min (p = 1.6E-16, CI 95%). Both SmartNav and X-ray had excellent sensitivity of 100% in identifying appropriate electrode position (p = 1.0). Tip fold-over was identified using both modalities in 3 cases with noted easier interpretation using SmartNav. Conclusion The Nucleus® SmartNav System significantly outperformed traditional X-ray imaging, offering a faster and more straightforward approach to assessing electrode positioning during cochlear implant surgery, thereby enhancing surgical efficiency and patient safety.

Non-invasive Transcutaneous Spinal Cord Stimulation Programming Recommendations for the Treatment of Upper Extremity Impairment in Tetraplegia

ObjectivesThis study analyzes the stimulation parameters implemented during two successful trials that used non-invasive transcutaneous spinal cord stimulation (tSCS) to effectively improve upper extremity function after chronic spinal cord injury (SCI). It proposes a framework to guide stimulation programming decisions for the successful translation of these techniques into the clinic. Materials and MethodsProgramming data from 60 participants who completed the Up-LIFT trial and from 17 participants who subsequently completed the LIFT Home trial were analyzed. All observations of stimulation amplitudes, frequencies, waveforms, and electrode configurations were examined. The incidence of adverse events and relatedness to stimulation parameters is reported. A comparison of parameter usage across the American Spinal Injury Association Impairment Scale (AIS) subgroups was conducted to evaluate stimulation strategies across participants with varying degrees of sensorimotor preservation. ResultsActive (cathodal) electrodes were typically placed between the C3/C4 and C6/C7 spinous processes. Most sessions featured return (anodal) electrodes positioned bilaterally over the anterior superior iliac spine, although clavicular placement was frequently used by 12 participants. Stimulation was delivered with a 10-kHz carrier frequency and typically a 30-Hz burst frequency. Biphasic waveforms were used in 83% of sessions. Average stimulation amplitudes were higher for biphasic waveforms. The AIS B subgroup required significantly higher amplitudes than did the AIS C and D subgroups. Device-related adverse events were infrequent, and not correlated with specific waveforms or amplitudes. Within the home setting, participants maintained their current amplitudes within 1% of the preset values. The suggested stimulation programming framework dictates the following hierarchical order of parameter adjustments: current amplitude, waveform type, active/return electrode positioning, and burst frequency, guided by clinical observations as required. ConclusionsThis analysis summarizes effective stimulation parameters from the trials and provides a decision-making framework for clinical implementation of tSCS for upper extremity functional restoration after SCI. The parameters are aligned with existing literature and proved safe and well tolerated by participants.

Development of improved spray system with effective electrical electrodes for aerosol removal: An experimental study in UTARTS facility

Safe reactor decommissioning, especially for damaged Fukushima Daiichi (1F) nuclear power plants, is vital for environmental safety. Key challenges include remotely cleaning radiation hotspots and cutting fuel debris within the damaged primary containment vessel. However, submicron radioactive Aerosol Particles (APs) can be generated, thus necessitating effective aerosol control and removal to avoid radioactive environmental pollution and reduce radiation exposure risks during 1F decommissioning. Flue gases containing submicron APs that result in environmental pollution can also generated from other industrial works, e.g., coal, mining and chemical sectors. Conventional water spray is difficult to scavenge these small APs. Although previous studies showed the effectiveness of charged droplets on accelerating aerosol removal, the charging configuration is also important to scavenging performance. Hence, this study performs aerosol scavenging experiments in our UTARTS facility with varying induction electrode designs. Experimental results show the saturation of scavenging efficiency at high voltage and indicate the importance of charging polarity. Moreover, proper configurations of electrode position, geometry and material are studied and discussed. Our findings can be beneficial for the improvement of spray system for aerosol removal to mitigate radioactivity release and minimize contaminated water production and have implications for gas purification in various environmental and chemical industries.

Percutaneous radiofrequency ablation of osteoid osteoma: results from 9 years of experience in a third-level center.

Osteoid osteoma is a benign bone tumor that accounts for roughly 2-3% of primary bone tumors and up to 10-12% of benigns bone neoplasms. It is most commonly seen in young adults, and shows male predominance. Over the last years, minimally invasive thermal ablation techniques such as radiofrequency ablation have gained popularity over classical surgery. In this study we evaluate results and complications of CT guided osteoid osteoma radiofrequency ablation. In this retrospective cohort study all patients that were diagnosed with osteoid osteoma and treated using radiofrequency ablation between January 2014 and December 2022 were included. Pain was assessed using Visual Analog Scale (VAS) pre and post procedure. Technical success was established as positioning of the radiofrequency electrode in the nidus. Primary clinical success was defined as absence of pain after one radiofrequency session. All patients that required a second radiofrequency ablation were included in the overall clinical success group. During the studied period, 61 osteoid osteoma radiofrequency ablations were performed. Fiftyseven of them were included in this study, 32 were men and 25 female. Pre procedure median pain was 9 according to VAS score. Only 23 patients were treated as outpatient, the rest stayed in hospital for 24 hours. Median follow up time was 21,7 months (SD 8,3). Biopsy was performed in 52 patients. Technical success was accomplished in 57 patients (100%). Primary clinical success was 80,7% (46 patients). Those who continued with pain or had recurrence after a symptoms free period (11 patients), were treated with a second radiofrequency ablation, achieving an overall success rate of 94,7%. Only one patient suffered a minor complication (1,7%). CT guided osteoid osteoma radiofrequency ablation is a safe, effective and low complication rate procedure, that can be performed on an outpatient basis. We believe it should be considered as a first line treatment option for osteoid osteoma.

Worldwide differences in surgeon intraoperative practices for cochlear implantation

Objective To characterize practice patterns of intraoperative imaging and/or functional confirmation of cochlear implant electrode location worldwide. Methods A cross-sectional survey of otolaryngologists performing cochlear implantation was conducted between March 1 and May 6, 2023. Participants were recruited worldwide using an international otologic society membership email list and at professional meetings. Ninety-seven of the 125 invited participants (78%) completed the survey. Participants were categorized by continent. Results North American surgeons use intraoperative X-rays more frequently than surgeons in Europe and Asia (p < 0.001). Otolaryngologists in Europe and Asia more frequently use no intraoperative imaging (p = 0.02). There is no regional difference between the intraoperative use of electrophysiologic instruments. European and Asian surgeons implant MED-EL devices (p = 0.012) more frequently than North American surgeons, who more frequently use Cochlear Corporation devices (p = 0.003). MED-EL use is related to less frequent intraoperative X-ray use (p = 0.02). Advanced Bionics use is related to more frequent intraoperative CT use (p = 0.03). No significant association existed between years of practice, number of cochlear implantation surgeries performed yearly, volume of pediatric CI practice, and use of intraoperative tools. Conclusion Intraoperative practice for radiologic and functional verification of cochlear implant electrode positioning varies worldwide. Practice guidelines may help establish a standard of care for cochlear implantation.