Use of intraoperative CT scanning for quality control assessment of cochlear implant electrode array placement*. (3rd March 2020)

• Record Type: Journal Article
• Authors: Labadie, Robert F.; Schefano, Antonio D.; Holder, Jourdan T.; Dwyer, Robert T.; Rivas, Alejandro; O'Malley, Matthew R.; Noble, Jack H.; Dawant, Benoit M.
• Is Part Of: Acta oto-laryngologica. Volume 140:Number 3(2020)
• Page Start: 206
• Page End: 211
• Publication Date: 2020-03-03
• Subjects: Cochlear implantation -- computerized tomography -- intraoperative imaging -- quality control; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2019.1698768
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: Imaging of cochlear implant (CI) electrode arrays (EAs) consists of intraoperative fluoroscopy to rule out tip fold-over and/or post-operative computerized tomography (CT) if concern exists regarding extrusion or misplacement of the EA. Intraoperative CT (iCT) can satisfy these current needs and enables specification of final intracochlear position. Aims/objectives: To describe iCT scanning of CI recipients at an academic medical center. Materials and methods: iCT was used to scan CI recipients within the operating room before recovering from general anesthesia. Results: In fiscal year 2019, 301 CI were placed (83 children, 218 adult). One hundred, seventy-five iCTs were performed (58% of total CIs) of which 52 were children (63% of pediatric CIs) and 123 were adult (57% of adult CIs). Of 7 CI surgeons, use of iCT ranged from 14% to 100% (mean 60%). Four tip fold-overs were identified and corrected intraoperatively. Surgeons reported using the images to improve technique (i.e. pulling back precurved EAs to improve perimodiolar positioning). Conclusion and significance: The current standard of care for CI is to insert EAs without feedback as to final location. iCT provides surgeons with rapid post-insertion feedback which allows detection and correction of suboptimally placed EAs as well as refinement of surgical technique.