scholarly journals Új műtéti képalkotó lehetőség a belsőfül-implantátum elektródasorának dinamikus helyzetmeghatározására

2021 ◽  
Vol 162 (22) ◽  
pp. 878-883
Author(s):  
Ádám Perényi ◽  
Roland Nagy ◽  
Bence Horváth ◽  
Bálint Posta ◽  
Balázs Dimák ◽  
...  
Keyword(s):  
Operating Room ◽  
Cochlear Implantation ◽  
Intraoperative Imaging ◽  
Electrode Array ◽  
Sound Waves ◽  
Hybrid Operating Room ◽  
Abnormal Position ◽  
Electrophysiological Tests ◽  
Cochlear Malformation ◽  
Electrode Insertion

Összefoglaló. Bevezetés: A cochlearis implantátum egy műtétileg behelyezett elektromos eszköz, amely az akusztikus hanghullámokat elektromos jelekké alakítja, közvetlenül a hallóideget stimulálja, így segíti a súlyos fokú hallássérüléssel vagy teljes hallásvesztéssel élők életét. Cochlearis implantációt követően a legjobb rehabilitációs eredmény elérésének technikai feltétele többek között az esetre szabott elektródaválasztás és az elektródasor teljes, kontrollált, szövődménymentes bejuttatása a scala tympaniba, miközben a cochlea belső struktúrája a lehető legkisebb mértékben sérül. A rutin intraoperatív elektrofiziológiai tesztek fontos információt adnak a készülék működőképességéről és a hallóideg stimulációjáról, azonban nem hagyatkozhatunk rájuk az elektródasor cochleán belüli helyzetének igazolásában. Mivel előfordulhat, hogy a rendelkezésre álló elektrofiziológiai vizsgálatok eredménye megfelelő, és mégis rendellenes helyzetbe kerül az elektróda, az arany standardot a képalkotó vizsgálatok jelentik. Módszer: Közleményünkben egy modern, hibrid műtő által nyújtott technológiai háttér új alkalmazási területét mutatjuk be. Szimultán kétoldali cochlearis implantációt végeztünk Cochlear Nucleus Slim Modiolar típusú perimodiolaris elektródasorral, a belső fül fejlődési rendellenességével rendelkező betegen. Az intraoperatív képalkotást Siemens Artis pheno C-karos robot digitális szubtrakciós angiográfiás rendszer biztosította valós idejű átvilágító és volumentomográfiás funkcióval. Eredmények: Az intraoperatív képalkotás által dinamikusan követhető az elektródasor bevezetésének folyamata, ellenőrizhető az elektródasor statikus helyzete, így kiváltható a rutinnak számító posztoperatív képalkotó vizsgálat. A rendellenes helyzetbe kerülő elektródasor pozíciója egy ülésben korrigálható, az újból bevezethető, így elkerülhető az újabb altatással járó, bizonytalan kimenetelű revíziós műtét. Következtetés: A hibrid műtő jól kontrollált, minimálisan invazív eljárások elvégzését biztosítja. Különösen a hallószerv fejlődési rendellenessége vagy egyéb, az elektródának a cochleába vezetését nehezítő rendellenesség esetén javasolt a műtői képalkotó diagnosztika. Orv Hetil. 2021; 162(22): 878–883. Summary. Introduction: The cochlear implant is a surgically inserted electrical device that converts acoustic sound waves into electrical signals to stimulate the cochlear nerve, thus helps the rehabilitation of people with severe to total hearing loss. One of the most important technical conditions for achieving the best rehabilitation result after cochlear implantation is the personalized choice of electrodes. Additionally, it is vital that there is a complete, controlled, uncomplicated delivery of the electrode array to the scala tympani while minimizing damage to the inner structures of the cochlea. Routine electrophysiological tests provide important information about device functionality and auditory nerve stimulation. However, they probably do not show an abnormal position of the electrode array within the cochlea. Thus, imaging studies remain the gold standard. Method: In our paper, we present a novel application field of the modern technological background provided by a hybrid operating room. Simultaneous bilateral cochlear implantation was performed with cochlear implants with perimodiolar electrode array (Nucleus Slim Modiolar) in a patient with cochlear malformation. Intraoperative imaging was provided by a Siemens Artis pheno C-arm robot digital subtraction angiography system with real-time fluoroscopy and volume tomography function. Results: Intraoperative imaging ensures dynamic follow-up of the introduction and static determination of the position of the electrode array and replaces routine postoperative imaging. If the electrode array was inserted in an abnormal position, the revision can be performed in the same sitting. Also, the revision surgery with a potential risk of uncertain outcome, alongside additional anaesthesia, can be prevented. Conclusion: The hybrid operating room ensures that well-controlled, minimally invasive procedures are performed. Intraoperative imaging can be imperative in malformed cochleae and conditions that may complicate electrode insertion. Orv Hetil. 2021; 162(22): 878–883.

scholarly journals Standard Programming of Retrograde Electrode Insertion via Middle-Turn Cochleostomy in Labyrinthitis Ossificans

2020 ◽  
pp. 014556132097486
Author(s):  
Mounika Reddy Y ◽  
Anjali Lepcha ◽  
Ann Mary Augustine ◽  
Ajay Philip ◽  
Philip Thomas
Keyword(s):  
Patient Preference ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Electrode Array ◽  
Labyrinthitis Ossificans ◽  
Electrode Insertion

Successful cochlear implantation in the setting of labyrinthitis ossificans is challenging. Various surgical techniques are described to circumvent the region of ossification and retrograde insertion of the electrode array is one such option. While reverse programming is often recommended in the case of retrograde electrode insertion, we present our experience of retrograde electrode insertion for labyrinthitis ossificans, where standard programming was adopted due to patient preference and provided satisfactory outcomes.

scholarly journals Imaging of Electrode Position after Cochlear Implantation with Flat Panel CT

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Diana Arweiler-Harbeck ◽  
Christoph Mönninghoff ◽  
Jens Greve ◽  
Thomas Hoffmann ◽  
Sophia Göricke ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Electrode Position ◽  
Flat Panel ◽  
Volume Computed Tomography ◽  
Metal Artefacts ◽  
Flat Panel Ct ◽  
Electrode Insertion

Background. Postoperative imaging after cochlear implantation is usually performed by conventional cochlear view (X-ray) or by multislice computed tomography (MSCT). MSCT after cochlear implantation often provides multiple metal artefacts; thus, a more detailed view of the implant considering the given anatomy is desirable. A quite new method is flat panel volume computed tomography. The aim of the study was to evaluate the method’s clinical use. Material and Methods. After cochlear implantation with different implant types, flat panel CT scan (Philips Allura) was performed in 31 adult patients. Anatomical details, positioning, and resolution of the different electrode types (MedEL, Advanced Bionics, and Cochlear) were evaluated interdisciplinary (ENT/Neuroradiology). Results. In all 31 patients cochlear implant electrode array and topographical position could be distinguished exactly. Spatial resolution and the high degree of accuracy were superior to reported results of MSCT. Differentiation of cochlear scalae by identification of the osseous spiral lamina was possible in some cases. Scanning artefacts were low. Conclusion. Flat panel CT scan allows exact imaging independent of implant type. This is mandatory for detailed information on cochlear electrode position. It enables us to perform optimal auditory nerve stimulation and allows feed back on surgical quality concerning the method of electrode insertion.

scholarly journals Role of Hybrid Operating Room: Present and Future

2020 ◽  
Author(s):  
Evan Qize Yuan ◽  
Calvin Sze Hang Ng
Keyword(s):  
Thoracic Surgery ◽  
Operating Room ◽  
Early Stage ◽  
Intraoperative Imaging ◽  
Cone Beam Ct ◽  
Pulmonary Nodules ◽  
High Definition ◽  
Hybrid Operating Room ◽  
Invasive Treatment ◽  
Patient Groups

With the dramatic progress of medical imaging modalities and growing needs for high-resolution intraoperative imaging in minimally invasive surgery, hybrid operative room (OR) has been developed as a powerful tool for different surgical scenarios. Under the guidance of high-definition cone beam CT (CBCT), an electromagnetic navigation bronchoscopy (ENB)-based marker implantation and subsequent localization of the pulmonary nodules can be implemented within a hybrid OR. Furthermore, the unparalleled real-time imaging capabilities and the ability to perform multiple tasks within the hybrid OR can facilitate image-guided single-port video-assisted thoracic surgery (iSPVATS), increasing the precision and improving outcomes of the procedure. With the help of a hybrid theatre, catheter-based thermal ablation can provide a safer and less invasive treatment option for select patient groups with early-stage non-small cell lung carcinomas (NSCLC) or metastases. In the future, the combination of hybrid operating room and other inspiring innovative techniques, such as robotic bronchoscopy, 3D-printing, natural orifice transluminal endoscopic surgery (NOTES) lung surgery could lead to a paradigm shift in the way thoracic surgery is conducted.

Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

2007 ◽  
Vol 122 (3) ◽  
pp. 246-252 ◽  
Author(s):  
S Berrettini ◽  
F Forli ◽  
S Passetti
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Electrode Array ◽  
Lateral Wall ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Electrode Insertion

AbstractThe preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear.We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing.The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.

Surgical considerations during cochlear implantation: the utility of temporal bone computed tomography

2021 ◽  
pp. 1-8
Author(s):  
Beomcho Jun ◽  
Sunwha Song
Keyword(s):  
Computed Tomography ◽  
Temporal Bone ◽  
Cochlear Implantation ◽  
Round Window ◽  
Three Dimensional ◽  
Electrode Placement ◽  
Posterior Tympanotomy ◽  
Electrode Insertion ◽  
Window Approach ◽  
Bone Structures

Abstract Objective This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography. Methods Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion. Results Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach. Conclusion It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.

Neuroendovascular training using multisource video-recording system in a hybrid operating room

2021 ◽  
Author(s):  
Satoshi Koizumi ◽  
Masaaki Shojima ◽  
Shogo Dofuku ◽  
Akira Saito ◽  
Seiji Nomura ◽  
...  
Keyword(s):  
Operating Room ◽  
Video Recording ◽  
Recording System ◽  
Hybrid Operating Room
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