1
|
Iso-Mustajärvi M, Silvast T, Heikka T, Tervaniemi J, Calixto R, Linder PH, Dietz A. Trauma After Cochlear Implantation: The Accuracy of Micro-Computed Tomography and Cone-Beam Fusion Computed Tomography Compared With Histology in Human Temporal Bones. Otol Neurotol 2023; 44:339-345. [PMID: 36843083 PMCID: PMC10022666 DOI: 10.1097/mao.0000000000003835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
HYPOTHESIS Micro-computed tomography (micro-CT) and cone-beam computed tomography (CBCT), in conjunction with the image fusion technique, may provide similar results for trauma assessment after cochlear implantation, with respect to the trauma evaluation in preclinical cochlear implant (CI) studies, as the histology. BACKGROUND Before clinical use, novel cochlear implant (CI) designs are tested in temporal bone (TB) studies for usability and risk evaluation. The criterion standard for evaluating intracochlear insertion trauma and electrode location has historically been with histological samples. Progress of modern imaging technology has created alternatives to classic histology. This study compares the micro-CT and CBCT fusion images between histological samples in a preclinical CI study. METHODS Fourteen freshly frozen TBs were inserted with a lateral wall research CI electrode. All TBs were scanned with CBCT preoperatively and postoperatively. After insertion, the TBs were prepared for micro-CT and histology. Twelve TBs underwent first a micro-CT and then the histological process. The CBCTs were used for image fusion, and all three different methods were used for intracochlear trauma evaluation. The results were compared between methods. RESULTS There were 4 of 14 translocations detected with the fusion image method and 3 of 12 with the micro-CT and histology. When compared, the trauma grades converged and were not statistically significant. CONCLUSION The trauma grading based on micro-CT is comparable to the histology. The image fusion technique based on CBCT is less accurate because it relies on an empirical assumption of the basal membrane localization, but it is clinically applicable.
Collapse
Affiliation(s)
| | - Tuomo Silvast
- SIB Labs Infrastructure Unit, Faculty of Science and Forestry, University of Eastern Finland
| | - Tuomas Heikka
- Department of Otorhinolaryngology, Kuopio University Hospital
| | - Jyrki Tervaniemi
- Department of Radiology, Kuopio University Hospital, Kuopio, Finland
| | | | - Pia H. Linder
- Department of Otorhinolaryngology, Kuopio University Hospital
| | - Aarno Dietz
- Department of Otorhinolaryngology, Kuopio University Hospital
| |
Collapse
|
2
|
Keklikoglou K, Arvanitidis C, Chatzigeorgiou G, Chatzinikolaou E, Karagiannidis E, Koletsa T, Magoulas A, Makris K, Mavrothalassitis G, Papanagnou ED, Papazoglou AS, Pavloudi C, Trougakos IP, Vasileiadou K, Vogiatzi A. Micro-CT for Biological and Biomedical Studies: A Comparison of Imaging Techniques. J Imaging 2021; 7:jimaging7090172. [PMID: 34564098 PMCID: PMC8470083 DOI: 10.3390/jimaging7090172] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 12/12/2022] Open
Abstract
Several imaging techniques are used in biological and biomedical studies. Micro-computed tomography (micro-CT) is a non-destructive imaging technique that allows the rapid digitisation of internal and external structures of a sample in three dimensions and with great resolution. In this review, the strengths and weaknesses of some common imaging techniques applied in biological and biomedical fields, such as optical microscopy, confocal laser scanning microscopy, and scanning electron microscopy, are presented and compared with the micro-CT technique through five use cases. Finally, the ability of micro-CT to create non-destructively 3D anatomical and morphological data in sub-micron resolution and the necessity to develop complementary methods with other imaging techniques, in order to overcome limitations caused by each technique, is emphasised.
Collapse
Affiliation(s)
- Kleoniki Keklikoglou
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
- Biology Department, University of Crete, 70013 Heraklion, Crete, Greece
- Correspondence:
| | - Christos Arvanitidis
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
- LifeWatch ERIC, 41071 Seville, Spain
| | - Georgios Chatzigeorgiou
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
| | - Eva Chatzinikolaou
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
| | - Efstratios Karagiannidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.S.P.)
| | - Triantafyllia Koletsa
- Department of Pathology, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Antonios Magoulas
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
| | - Konstantinos Makris
- Medical School, University of Crete, 71003 Heraklion, Crete, Greece; (K.M.); (G.M.); (A.V.)
| | - George Mavrothalassitis
- Medical School, University of Crete, 71003 Heraklion, Crete, Greece; (K.M.); (G.M.); (A.V.)
- IMBB, FORTH, 70013 Heraklion, Crete, Greece
| | - Eleni-Dimitra Papanagnou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (E.-D.P.); (I.P.T.)
| | - Andreas S. Papazoglou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (A.S.P.)
| | - Christina Pavloudi
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
| | - Ioannis P. Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens (NKUA), 15784 Athens, Greece; (E.-D.P.); (I.P.T.)
| | - Katerina Vasileiadou
- Hellenic Centre for Marine Research (HCMR), Institute of Marine Biology, Biotechnology and Aquaculture (IMBBC), P.O. Box 2214, 71003 Heraklion, Crete, Greece; (C.A.); (G.C.); (E.C.); (A.M.); (C.P.); (K.V.)
| | - Angeliki Vogiatzi
- Medical School, University of Crete, 71003 Heraklion, Crete, Greece; (K.M.); (G.M.); (A.V.)
| |
Collapse
|
3
|
Cochlear Implantation With a Novel Long Straight Electrode: the Insertion Results Evaluated by Imaging and Histology in Human Temporal Bones. Otol Neurotol 2019; 39:e784-e793. [PMID: 30199496 DOI: 10.1097/mao.0000000000001953] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS To evaluate the insertion results of a novel straight array (EVO) by detailed imaging and subsequent histology in human temporal bones (TB). BACKGROUND The main focuses of modern cochlear implant surgery are to prevent damage to the intracochlear structures and to preserve residual hearing. This is often achievable with new atraumatic electrode arrays in combination with meticulous surgical techniques. METHODS Twenty fresh-frozen TBs were implanted with the EVO. Pre- and postoperative cone beam computed tomography scans were reconstructed and fused for an artifact-free representation of the electrode. The array's vertical position was quantified in relation to the basilar membrane on basis of which trauma was classified (Grades 0-4). The basilar membrane location was modeled from previous histologic data. The TBs underwent subsequent histologic examination. RESULTS The EVOs were successfully inserted in all TBs. Atraumatic insertion (Grades 0-1) were accomplished in 14 of 20 TBs (70%). There were three apical translocations, and two basal translocations due to electrode bulging. One TB had multiple translocations. The sensitivity and specificity of imaging for detecting insertion trauma (Grades 2-4) was 87.5% and 97.3.0%, respectively. CONCLUSION Comparable insertion results as reported for other arrays were also found for the EVO. Insertion trauma can be mostly avoided with meticulous insertion techniques to prevent bulging and by limiting the insertion depth angle to 360 degrees. The image fusion technique is a reliable tool for evaluating electrode placement and is feasible for trauma grading.
Collapse
|
4
|
Rebscher S, Zhou DD, Zeng FG. Development and Clinical Introduction of the Nurotron Cochlear Implant Electrode Array. J Int Adv Otol 2019; 14:392-400. [PMID: 30644380 DOI: 10.5152/iao.2018.6285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As the only medical device used in the treatment for deafness, the cochlear implant has benefited to more than half a million individuals worldwide. However, the device has limited penetration due to its high cost, especially in low- and middle-income countries. China alone has 27.8 million deaf people, but less than 100,000 of them have received a cochlear implant. The Nurotron Venus device was developed to address the need for an affordable yet safe and effective cochlear implant. The present study describes the design, development, and evaluation of the Nurotron intracochlear electrode array. The standard array is 22 mm in length from the round window marker to the apical tip of the carrier and has 24 electrodes, with a surface area of 0.32 mm2 and center-to-center spacing of 0.85 mm. The Nurotron array has been tested to meet the mechanical, chemical, and electrical requirements specified by the ISO Standard 14708-07. Human temporal bone and clinical trial results showed that the Nurotron array is easy to insert (7.8/10 rating with 10 indicating the highest ease of use) and has a low complication rate (12.5%) of severe insertion trauma while achieving high device stability and reliability (6 array failures in 43,000 patient years of experience). As a critical component, the Nurotron array has contributed to the high level of Nurotron implant speech performance, equivalent to that produced by other existing devices. The Nurotron device has benefited 10,000 deaf people and helped reduce the unit cost from US$25,000 in 2011 to US$4,620 in 2017 through the Chinese Government Tender Program. New, slim, and micromachined electrodes are being developed to further improve performance and accessibility.
Collapse
Affiliation(s)
- Stephen Rebscher
- Department of Otolaryngology, University of California San Francisco, San Francisco, USA
| | | | - Fan-Gang Zeng
- Department of Otolaryngology, University of California Irvine, Irvine, USA
| |
Collapse
|
5
|
Cochlear Implant Insertion Axis Into the Basal Turn: A Critical Factor in Electrode Array Translocation. Otol Neurotol 2019; 39:168-176. [PMID: 29194215 DOI: 10.1097/mao.0000000000001648] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS An inappropriate insertion axis leads to intracochlear trauma during cochlear implantation (CI). BACKGROUND Few studies assessed the relationship between the insertion axis and the electrode scalar location. METHODS Preimplantation cone-beam CT (CBCT) was performed on 12 human temporal bones. In five temporal bones, an optimal insertion axis was planned, due to the impossibility to attain the ST centerline from the posterior tympanotomy, because of facial canal position. In the seven other temporal bones, an inaccurate insertion axis was intentionally planned (optimal axis+15 degrees). Automated CI array insertion according to the planned axis was performed with a motorized insertion tool driven by a navigated robot-based arm. The cochlea and basilar membrane were segmented from the preimplantation CBCT and the array segmented from the postimplantation CBCT to construct a merged final three-dimensional (3D) model. Microscopical and 3D analysis were performed to determine the intracochlear trauma at the level of each electrode. RESULTS A good agreement was observed in determining electrode position between microscopic analysis and the 3D model (Cohen's kappa k = 0.67). The angle of approach to the ST centerline was associated with the number of electrodes inserted into the ST (r = -0.65, p = 0.02, [95% CI -0.90 to -0.11] Spearman's rank correlation). CONCLUSION A 3D reconstruction model was effective in determining the array position in the cochlea scalae. Our data indicate that the angle of approach to the ST centerline is a critical factor in intracochlear trauma. Additional studies should be conducted to assess the importance of the insertion axis with other array designs.
Collapse
|
7
|
Tang J, Tang X, Li Z, Liu Y, Tan S, Li H, Ke R, Wang Z, Gong L, Tang A. Anatomical Variations of the Human Cochlea Determined from Micro-CT and High-Resolution CT Imaging and Reconstruction. Anat Rec (Hoboken) 2018; 301:1086-1095. [PMID: 29160929 DOI: 10.1002/ar.23730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/21/2017] [Accepted: 09/12/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Jie Tang
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Xianglong Tang
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Zhenhua Li
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Yikang Liu
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - SongHua Tan
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Heng Li
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - RongDan Ke
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Zhi Wang
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - Li Gong
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| | - AnZhou Tang
- Department of Otolaryngology Head and Neck Surgery; First Affiliated Hospital of Guangxi Medical University; Guangxi Nanning 530000 People's Republic of China
| |
Collapse
|
8
|
Hanekom T, Hanekom JJ. Three-dimensional models of cochlear implants: A review of their development and how they could support management and maintenance of cochlear implant performance. NETWORK (BRISTOL, ENGLAND) 2016; 27:67-106. [PMID: 27136100 DOI: 10.3109/0954898x.2016.1171411] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Three-dimensional (3D) computational modeling of the auditory periphery forms an integral part of modern-day research in cochlear implants (CIs). These models consist of a volume conduction description of implanted stimulation electrodes and the current distribution around these, coupled with auditory nerve fiber models. Cochlear neural activation patterns can then be predicted for a given input stimulus. The objective of this article is to present the context of 3D modeling within the field of CIs, the different models, and approaches to models that have been developed over the years, as well as the applications and potential applications of these models. The process of development of 3D models is discussed, and the article places specific emphasis on the complementary roles of generic models and user-specific models, as the latter is important for translation of these models into clinical application.
Collapse
Affiliation(s)
- Tania Hanekom
- a Bioengineering, Department of Electrical, Electronic and Computer Engineering , University of Pretoria , Pretoria , South Africa
| | - Johan J Hanekom
- a Bioengineering, Department of Electrical, Electronic and Computer Engineering , University of Pretoria , Pretoria , South Africa
| |
Collapse
|