On the Accuracy of Clinical Insertion Angle Predictions With a Surgical Planning Platform for Cochlear Implantation

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emilio Avallone ◽  
Thomas Lenarz ◽  
Max E. Timm
Keyword(s):  
Cochlear Implantation ◽  
Surgical Planning ◽  
Insertion Angle

Post-operative problems and complications in 313 consecutive cochlear implantations

2008 ◽  
Vol 123 (5) ◽  
pp. 492-496 ◽  
Author(s):  
T Ovesen ◽  
L V Johansen
Keyword(s):  
Cochlear Implantation ◽  
Surgical Planning ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Safe Procedure ◽  
Tertiary Referral Centre ◽  
Antibiotic Resistant ◽  
Danish Patient ◽  
Study Population ◽  
Radical Cavity

AbstractObjective:To describe problems and complications associated with cochlear implantation, and their management, in a Danish patient population comprising both paediatric and adult patients.Design:Retrospective chart review.Setting:Tertiary referral centre.Subjects:Three hundred and thirteen consecutive cochlear implantations were studied. The median age of the study population was 10 years. Sixty per cent of patients were children and 40 per cent were adult; 52 per cent were female and 48 per cent were male.Intervention:Two hundred and ninety-four patients received a Cochlear Nucleus®implant. The remaining 19 received an Advanced Bionics implant.Main outcome measure:Presence of problems and complications after cochlear implantation.Results:Post-operative complications were found in 15.7 per cent of patients. The majority of these complications (11.2 per cent) were minor; 4.5 per cent were major. The major complications included one patient with meningitis, one patient with multiple antibiotic resistantStaphylococcus aureusinfection of a radical cavity, and one diabetic patient who developed a severe skin infection and whose implant became exposed.Conclusion:Cochlear implantation is a safe procedure within the studied setting. However, it is essential that careful attention be paid to surgical planning and technique, and it is important that healthcare staff and patients be aware of the possible problems and complications.

Cochlear implant electrode array misplacement: a cautionary case report

2012 ◽  
Vol 126 (4) ◽  
pp. 414-417 ◽  
Author(s):  
E Muzzi ◽  
P Boscolo-Rizzo ◽  
R Santarelli ◽  
M A Beltrame
Keyword(s):  
Case Report ◽  
Cochlear Implantation ◽  
Internal Auditory Canal ◽  
Electrode Array ◽  
Auditory Neuropathy ◽  
Cerebrospinal Fluid Leakage ◽  
High Resolution Computed Tomography ◽  
Insertion Angle ◽  
Canal Wall Down ◽  
Operative Assessment

AbstractObjective:To report a series of pitfalls and complications in a case of cochlear implantation.Method:Case report.Results:An 11-year-old boy affected by auditory neuropathy underwent cochlear implantation. Intra-operative assessment was apparently consistent with correct insertion of the electrode array into the cochlea. However, subsequent high resolution computed tomography revealed that the entire electrode array was curled up within the vestibule. Revision surgery was complicated by cerebrospinal fluid leakage. A straight probe was repeatedly inserted into the internal auditory canal, before conversion to a canal wall down procedure and appropriate positioning of the electrode array.Conclusion:In this case, mild anteriorisation of the facial nerve created an awkward insertion angle for the electrode array via the retro-facial route, which may have triggered the described series of adverse events.

scholarly journals Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation

2021 ◽  
Author(s):  
Franz-Tassilo Müller-Graff ◽  
Lukas Ilgen ◽  
Philipp Schendzielorz ◽  
Johannes Voelker ◽  
Johannes Taeger ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cochlear Implantation ◽  
Surgical Planning ◽  
Imaging Data ◽  
Flat Panel ◽  
Implanted Electrodes ◽  
Volume Computed Tomography ◽  
Planning Software ◽  
Postoperative Setting

Abstract Purpose For further improvements in cochlear implantation, the measurement of the cochlear duct length (CDL) and the determination of the electrode contact position (ECP) are increasingly in the focus of clinical research. Usually, these items were investigated by multislice computed tomography (MSCT). The determination of ECP was only possible by research programs so far. Flat-panel volume computed tomography (fpVCT) and its secondary reconstructions (fpVCTSECO) allow for high spatial resolution for the visualization of the temporal bone structures. Using a newly developed surgical planning software that enables the evaluation of CDL and the determination of postoperative ECP, this study aimed to investigate the combination of fpVCT and otological planning software to improve the implementation of an anatomically based cochlear implantation. Methods Cochlear measurements were performed utilizing surgical planning software in imaging data (MSCT, fpVCT and fpVCTSECO) of patients with and without implanted electrodes. Results Measurement of the CDL by the use of an otological planning software was highly reliable using fpVCTSECO with a lower variance between the respective measurements compared to MSCT. The determination of the inter-electrode-distance (IED) between the ECP was improved in fpVCTSECO compared to MSCT. Conclusion The combination of fpVCTSECO and otological planning software permits a simplified and more reliable analysis of the cochlea in the pre- and postoperative setting. The combination of both systems will enable further progress in the development of an anatomically based cochlear implantation.

MAGNETIC RESONANCE IMAGING IN SURGICAL PLANNING FOR COCHLEAR IMPLANTATION

1993 ◽  
Vol 86 (Supplement) ◽  
pp. 90
Author(s):  
Moises Arriaga ◽  
David Carrier ◽  
Phyllis Chapel ◽  
Richard Kluznick
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cochlear Implantation ◽  
Surgical Planning ◽  
Resonance Imaging

scholarly journals Fusion of Technology in Cochlear Implantation Surgery: Investigation of Fluoroscopically Assisted Robotic Electrode Insertion

2021 ◽  
Vol 8 ◽  
Author(s):  
Greg Eigner Jablonski ◽  
Benedicte Falkenberg-Jensen ◽  
Marie Bunne ◽  
Muneera Iftikhar ◽  
Ralf Greisiger ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Inner Ear ◽  
Cochlear Implantation ◽  
Human Cadaver ◽  
Insertion Angle ◽  
The Status ◽  
Electrode Insertion ◽  
Temporal Bones ◽  
Insertion Process

The HEARO cochlear implantation surgery aims to replace the conventional wide mastoidectomy approach with a minimally invasive direct cochlear access. The main advantage of the HEARO access would be that the trajectory accommodates the optimal and individualized insertion parameters such as type of cochlear access and trajectory angles into the cochlea. To investigate the quality of electrode insertion with the HEARO procedure, the insertion process was inspected under fluoroscopy in 16 human cadaver temporal bones. Prior to the insertion, the robotic middle and inner ear access were performed through the HEARO procedures. The status of the insertion was analyzed on the post-operative image with Siemens Artis Pheno (Siemens AG, Munich, Germany). The completion of the full HEARO procedure, including the robotic inner ear access and fluoroscopy electrode insertion, was possible in all 16 cases. It was possible to insert the electrode in all 16 cases through the drilled tunnel. However, one case in which the full cochlea was not visible on the post-operative image for analysis was excluded. The post-operative analysis of the electrode insertion showed an average insertion angle of 507°, which is equivalent to 1.4 turns of the cochlea, and minimal and maximal insertion angles were recorded as 373° (1 cochlear turn) and 645° (1.8 cochlear turn), respectively. The fluoroscopy inspection indicated no sign of complications during the insertion.

scholarly journals Scala vestibuli cochlear implant supported by 3D modeling of the inner ear

2021 ◽  
Author(s):  
Clemens Holzmeister ◽  
Alexandros Andrianakis ◽  
Peter Kiss ◽  
Ulrich Moser ◽  
Matthias Graupp
Keyword(s):  
Inner Ear ◽  
Cochlear Implantation ◽  
Surgical Planning ◽  
Present Report ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
Electrode Placement ◽  
3D Segmentation ◽  
Brainstem Response ◽  
Scala Vestibuli

SummaryPatients with scala tympani (ST) ossification present a distinct surgical challenge. Three-dimensional (3D) segmentation of the inner ear offers accurate identification of ossification and surgical planning of the cochleostomy to access the scala vestibuli. The scala vestibuli placement of cochlear implantation electrode is an alternate solution in these patients and is well supported by the literature.The present report describes a case of cochlear implantation in the scala vestibuli assisted by 3D segmentation of the cochlea for a patient with ossification in the ST and reviews the relevant literature. Clinical presentation of a 45-year-old Austrian female who was referred with a history of sudden sensorineural hearing loss 2 years ago in the right ear, confirmed by pure tone audiometry (PTA) and acoustically evoked auditory brainstem response (ABR). 3D segmentation of the inner ear identified the extent of ossification in the ST and assisted in the surgical planning of cochleostomy drilling anterior-superior to the round window to access the scala vestibuli for the electrode placement. Postoperative computed tomography (CT) to confirm the electrode placement in the scala vestibuli and PTA was performed to assess the hearing threshold following the cochlear implantation. Postoperative CT confirmed the full insertion of a flexible electrode. The hearing threshold measured by PTA was ≤ 40 dB across all frequencies tested. Review of the literature identified a total of 13 published reports on cochlear implantation electrode placement in scala vestibuli in cases with ossification in the ST.

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