1
|
Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Voelker J, Hagen R, Rak K. [Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN® for cochlear implantation. German version]. HNO 2024; 72:687-701. [PMID: 38587661 PMCID: PMC11422278 DOI: 10.1007/s00106-024-01461-8] [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] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
Collapse
Affiliation(s)
- Franz-Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - David P Herrmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Anja Kurz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| |
Collapse
|
2
|
Cramer J, Böttcher-Rebmann G, Lenarz T, Rau TS. A method for accurate and reproducible specimen alignment for insertion tests of cochlear implant electrode arrays. Int J Comput Assist Radiol Surg 2024; 19:1883-1893. [PMID: 37204650 DOI: 10.1007/s11548-023-02930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/19/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE The trajectory along which the cochlear implant electrode array is inserted influences the insertion forces and the probability for intracochlear trauma. Controlling the trajectory is especially relevant for reproducible conditions in electrode insertion tests. Using ex vivo cochlear specimens, manual alignment of the invisibly embedded cochlea is imprecise and hardly reproducible. The aim of this study was to develop a method for creating a 3D printable pose setting adapter to align a specimen along a desired trajectory toward an insertion axis. METHODS Planning points of the desired trajectory into the cochlea were set using CBCT images. A new custom-made algorithm processed these points for automated calculation of a pose setting adapter. Its shape ensures coaxial positioning of the planned trajectory to both the force sensor measuring direction and the insertion axis. The performance of the approach was evaluated by dissecting and aligning 15 porcine cochlear specimens of which four were subsequently used for automated electrode insertions. RESULTS The pose setting adapter could easily be integrated into an insertion force test setup. Its calculation and 3D printing was possible in all 15 cases. Compared to planning data, a mean positioning accuracy of 0.21 ± 0.10 mm at the level of the round window and a mean angular accuracy of 0.43° ± 0.21° were measured. After alignment, four specimens were used for electrode insertions, demonstrating the practical applicability of our method. CONCLUSION In this work, we present a new method, which enables automated calculation and creation of a ready-to-print pose setting adapter for alignment of cochlear specimens in insertion test setups. The approach is characterized by a high level of accuracy and reproducibility in controlling the insertion trajectory. Therefore, it enables a higher degree of standardization in force measurement when performing ex vivo insertion tests and thereby improves reliability in electrode testing.
Collapse
Affiliation(s)
- Jakob Cramer
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Georg Böttcher-Rebmann
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Cluster of Excellence EXC 2177/1 "Hearing4all", Hannover Medical School, Hannover, Germany
| | - Thomas S Rau
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Cluster of Excellence EXC 2177/1 "Hearing4all", Hannover Medical School, Hannover, Germany
| |
Collapse
|
3
|
Fatani N, Abdelsamad Y, Alsanosi A. Influence of Cochlear Anatomy on Intraoperative Electrically Evoked Compound Action Potentials. J Clin Med 2024; 13:4716. [PMID: 39200858 PMCID: PMC11355649 DOI: 10.3390/jcm13164716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/10/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024] Open
Abstract
Objective: The electrically evoked compound action potential (ECAP) is an objective measure to indirectly assess spiral ganglion neurons. The ECAP provides inputs about the prognoses of cochlear implant (CI) recipients. Several factors such as cochlear morphology can affect ECAP measurements. This study aims to investigate the variation effect of cochlear parameters on intraoperative ECAP thresholds. Methods: This is a retrospective study on patients who underwent CI surgery with normal inner ear morphology at our center between 2017 and 2023. Cochlear anatomical parameters, including diameter (A value), width (B value), and height (H value), as well as cochlear duct length (CDL), were measured pre-operatively using OTOPLAN software (Version 3.0). Cochlear implant intraoperative objective measures were also collected. The correlation between the cochlear parameters and intraoperative objective measures was studied. Results: A total of 45 patients underwent cochlear implantation. The mean age was 2.4 ± 0.9 years. The mean CDL and cochlear coverage values were 33.2 ± 2.0 mm and 76.0 ± 5.7%, respectively. The ECAP threshold increased toward basal electrodes, with ECAP values as follows: apical 13.1 ± 3.8; middle 14.3 ± 3.7; and basal 15.6 ± 4.8. Additionally, the A, B, and H values showed a positive correlation with ECAP thresholds in different cochlear regions. The B value showed a significant moderate correlation with ECAP thresholds in the middle and basal electrodes but not in the apical electrodes. Conclusions: Cochlear anatomical parameters correlate with intraoperative ECAP thresholds. The B value showed a significant association with ECAP thresholds in the middle and basal electrodes. These findings could delineate the impact of the B value in CI and optimize electrode selection. Further research is required to study this correlation and its impact on postoperative outcomes.
Collapse
Affiliation(s)
- Nawaf Fatani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| | | | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| |
Collapse
|
4
|
Liu D, Wang X, Zhou W, Tang A. Evaluation of automatic cochlear dimension measurement using ALPACA: a comparative study. Acta Otolaryngol 2024; 144:409-416. [PMID: 39154208 DOI: 10.1080/00016489.2024.2391500] [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] [Received: 06/09/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Cochlear dimension measurements are critical in diagnosing and managing congenital sensorineural hearing loss. OBJECTIVES To evaluate the feasibility and reliability of an automated landmark approach for measuring cochlear dimensions (A-, B- and H-values). MATERIAL AND METHODS Cochlear parameters from 100 patients were measured by MPR, manual three-dimensional and ALPACA. We assessed intra- and inter-observer reliability as well as inter-method reliability. Statistical analyses were conducted to detect differences between the right and left ears, as well as to assess the relevance of the values obtained using ALPACA. RESULTS All A-, B-, and H-values measured by the various methods showed a high intra-observer reliability with intra-class correlation coefficients (ICC) ranging from 0.70 to 0.99, and values gained by ALPACA reaching the highest ICC. Inter-method reliability was at a good level with ICC ranging from 0.51 to 0.86. There were no significant differences between the right and left ears' measured values. Obvious positive correlations existed among cochlear dimensions measured by ALPACA. CONCLUSIONS AND SIGNIFICANCE The ALPACA method can be used to measure cochlear dimensions. Values obtained by the method demonstrate high reliability and consistency with a significant reduction in intra-observer variability compared to results from conventional MPR and manual 3D measurements.
Collapse
Affiliation(s)
- Di Liu
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xuesong Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenwen Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Anzhou Tang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| |
Collapse
|
5
|
Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Völker J, Hagen R, Rak K. Comprehensive literature review on the application of the otological surgical planning software OTOPLAN® for cochlear implantation. HNO 2024:10.1007/s00106-023-01417-4. [PMID: 38861031 DOI: 10.1007/s00106-023-01417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 06/12/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
Collapse
Affiliation(s)
- Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany.
| | - Björn Spahn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - David P Herrmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Johannes Völker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Straße 11, 97080, Wuerzburg, Germany
| |
Collapse
|
6
|
Athanasopoulos M, Samara P, Athanasopoulos I. Advances in 3D Inner Ear Reconstruction Software for Cochlear Implants: A Comprehensive Review. Methods Protoc 2024; 7:46. [PMID: 38921825 PMCID: PMC11207030 DOI: 10.3390/mps7030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Auditory impairment stands as a pervasive global issue, exerting significant effects on individuals' daily functioning and interpersonal engagements. Cochlear implants (CIs) have risen as a cutting-edge solution for severe to profound hearing loss, directly stimulating the auditory nerve with electrical signals. The success of CI procedures hinges on precise pre-operative planning and post-operative evaluation, highlighting the significance of advanced three-dimensional (3D) inner ear reconstruction software. Accurate pre-operative imaging is vital for identifying anatomical landmarks and assessing cochlear deformities. Tools like 3D Slicer, Amira and OTOPLAN provide detailed depictions of cochlear anatomy, aiding surgeons in simulating implantation scenarios and refining surgical approaches. Post-operative scans play a crucial role in detecting complications and ensuring CI longevity. Despite technological advancements, challenges such as standardization and optimization persist. This review explores the role of 3D inner ear reconstruction software in patient selection, surgical planning, and post-operative assessment, tracing its evolution and emphasizing features like image segmentation and virtual simulation. It addresses software limitations and proposes solutions, advocating for their integration into clinical practice. Ultimately, this review underscores the impact of 3D inner ear reconstruction software on cochlear implantation, connecting innovation with precision medicine.
Collapse
Affiliation(s)
- Michail Athanasopoulos
- Otolaryngology-Head & Neck Surgery, Athens Pediatric Center, 15125 Athens, Greece; (M.A.); (I.A.)
| | - Pinelopi Samara
- Children’s Oncology Unit “Marianna V. Vardinoyannis-ELPIDA”, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Ioannis Athanasopoulos
- Otolaryngology-Head & Neck Surgery, Athens Pediatric Center, 15125 Athens, Greece; (M.A.); (I.A.)
| |
Collapse
|
7
|
Fan X, Yang T, Fan Y, Song W, Gu W, Lu X, Chen Y, Chen X. Hearing outcomes following cochlear implantation with anatomic or default frequency mapping in postlingual deafness adults. Eur Arch Otorhinolaryngol 2024; 281:719-729. [PMID: 37548704 DOI: 10.1007/s00405-023-08151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE The aim of this study was to compare the outcomes of different mapping procedures based on anatomic or default frequency distribution in postlingual deafness adults who underwent cochlear implantation (CI). METHODS Forty-eight adults with postlingual deafness who underwent CI (MED-EL) from January 2021 to May 2022 in our hospital were prospectively recruited. The participants were randomly assigned to two groups (the anatomic group and the default group). Postoperative computerized tomography (CT) scans were evaluated with Otoplan® to determine the angular insertion depth (AID) and the specific locations of the intracochlear electrodes. Anatomic maps were imported into MAESTRO 9.0 software (MED-EL) for anatomy-based fitting for anatomic group, while default mapping program was set up for the default group. Hearing thresholds, Speech Recognition Scores (SRS), and subjects' auditory and musical abilities were evaluated 1 year after using the CI. Differences were determined in two groups using Stata statistical software, with significance defined as p < 0.05. RESULTS SRS under noisy conditions was significantly greater for anatomic group than the default group (p = 0.02). Under quiet conditions, however, mean hearing thresholds (0.5, 1, 2, and 4 kHz) and SRS did not differ significantly between the two groups (p = 0.07). Modified questionnaires showed that auditory (p = 0.02) and musical (p = 0.01) quality were significantly better following the anatomic mapping than the default procedure. CONCLUSION CI program based on the anatomic distribution may bring better SRS under noise conditions as well as better auditory and musical qualities than based on the default frequency distribution.
Collapse
Affiliation(s)
- Xinmiao Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China
| | - Tengyu Yang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China
| | - Yue Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China
| | - Wenjie Song
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China
| | - Wei Gu
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China
| | - Xiaoping Lu
- Department of Radiology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Xiaowei Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #1 Shuaifuyuan, Beijing, 100730, People's Republic of China.
| |
Collapse
|
8
|
Alahmadi A, Abdelsamad Y, Thabet EM, Hafez A, Alghamdi F, Badr KM, Alghamdi S, Hagr A. Advancing Cochlear Implant Programming: X-ray Guided Anatomy-Based Fitting. Otol Neurotol 2024; 45:107-113. [PMID: 38206059 DOI: 10.1097/mao.0000000000004069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Anatomy-based fitting (ABF) is a new research area in the field of cochlear implants (CIs). Despite the reported benefits and acceptable levels of ABF among CI recipients, some limitations remain, like the postoperative computed tomography (CT) scan, which is preferred for confirming electrode array insertion. OBJECTIVE This study aimed to investigate the feasibility of using plain film radiography (X-ray) for postoperative electrode detection and for building ABF as an alternative to CT. METHODS A total of 53 ears with CI were studied. All cases had routine post-insertion X-rays in the cochlear view and additionally underwent postoperative CT. The insertion angles and center frequencies measured by two independent observers were compared for each imaging modality. The angular insertion depth and center frequencies resulting from the X-ray and CT scans were then compared. RESULTS No significant differences were observed between the X-ray- and CT-measured angles for the electrode contacts. Radiographic measurements between the two readers showed an almost perfect (≥0.8) or substantial (0.71) intraclass correlation coefficient along the electrode contacts. X-ray images showed a mean difference of 4.7 degrees from CT. The mean semitone deviation of the central frequency between the CT and X-ray images was 0.6. CONCLUSIONS X-ray imaging provides a valid and easy-to-perform alternative to CT imaging, with less radiation exposure and lower costs. The radiographs showed excellent concordance with the CT-measured angular insertion depth and consequently with the central frequency for most electrode contacts. Therefore, plain X-ray could be a viable alternative in building ABF for the CI recipients.
Collapse
Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| | | | | | - Ahmed Hafez
- Electrophysiology Department, MED-EL GmbH, Riyadh, Saudi Arabia
| | | | | | | | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
9
|
Sarwar Z, Ahmed J, Saqulain G, Khan MIJ. Cochlear duct length in Pakistani cochlear implant recipients gender, age and side association: A Radiological Measure. Pak J Med Sci 2024; 40:41-45. [PMID: 38196493 PMCID: PMC10772454 DOI: 10.12669/pjms.40.1.7426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 09/19/2023] [Indexed: 01/11/2024] Open
Abstract
Objectives To analyze the gender, age and side association of cochlear duct length in Pakistani-Asian cochlear implant recipient population based on computed tomography imaging study. Methods Current study retrospectively studied charts of cases who underwent cochlear implantation at the Department of Otolaryngology & Auditory Implant Centre, Capital Hospital Islamabad, over a period of two years from 1st May 2017 to 30th April 2019. These included 200 cases of both genders and of any age. In addition to basic demographic data, computed tomography findings of the temporal bone were utilized to measure the cochlear duct length. Data was analyzed using SPSS Version 23. Results Study revealed a mean Cochlear duct length of 29.935±2.173mm (range: 25.12 to 37.60) with significant (p<0.001) association with gender with longer cochlear duct in males compared to females on right (30.50±2.384 vs. 29.36±1.887) and on left side (30.50±2.236 vs.29.32±1.935). However, no significant difference was noted for side with slightly longer cochlear duct on the right side compared to left (29.95±2.224 vs.29.92±2.171). Also, no significant association with age was noted with p=0.578 & p=0.824 for right and left side respectively. Conclusion Pakistani population is characterized by a short mean CDL of 29.935±2.173 mm with significant association (p<0.001) with gender with longer cochlear duct length in males; and side with larger CDL on right side. However, no significant association with age was noted.
Collapse
Affiliation(s)
- Zahra Sarwar
- Dr. Zahra Sarwar, MBBS. Post-Graduate FCPS Trainee ENT Department, KRL Hospital, Islamabad, Pakistan
| | - Jawwad Ahmed
- Dr. Jawwad Ahmed, FCPS. Implant Surgeon, Department of Otorhinolaryngology Capital Hospital PGMI, Islamabad, Pakistan
| | - Ghulam Saqulain
- Dr. Ghulam Saqulain, FCPS. Head of Department/ Professor of Otorhinolaryngology Capital Hospital PGMI, Islamabad, Pakistan
| | - Muhammad Iqbal Javed Khan
- Dr. Muhammad Iqbal Javed Khan, FRCS. Consultant Otologist and Skull Base Surgeon, Bradford Teaching Hospitals NHS Foundation Trust, United Kingdom
| |
Collapse
|
10
|
Alahmadi A, Abdelsamad Y, Dhanasingh A, Almuhawas F, Alsanosi A. Enhancing cochlear duct length estimation by incorporating second-turn parameters. Sci Rep 2023; 13:21496. [PMID: 38057331 PMCID: PMC10700305 DOI: 10.1038/s41598-023-48641-0] [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] [Received: 10/19/2022] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
Estimating insertion depth, cochlear duct length (CDL), and other inner ear parameters is vital to optimizing cochlear implantation outcomes. Most current formulas use only the basal turn dimensions for CDL prediction. In this study, we investigated the importance of the second turn parameters in estimating CDL. Two experienced neuro-otologists blindly used segmentation software to measure (in mm) cochlear parameters, including basal turn diameter (A), basal turn width (B), second-turn diameter (A2), second-turn width (B2), CDL, first-turn length, and second-turn length (STL). These readings were taken from 33 computed tomography (CT) images of temporal bones from anatomically normal ears. We constructed regression models using A, B, A2, and B2 values fitted to CDL, two-turn length, and five-fold cross-validation to ensure model validity. CDL, A value, and STL were longer in males than in females. The mean B2/A2 ratio was 0.91 ± 0.06. Adding A2 and B2 values improved CDL prediction accuracy to 86.11%. Therefore, we propose a new formula for more accurate CDL estimation using A, B, A2, and B2 values. In conclusion, the findings of this study revealed a notable improvement in the prediction of two-turn length (2TL), and CDL by clinically appreciable margins upon adding A2 and B2 values to the prediction formulas.
Collapse
Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), King Saud University Medical City (KSUMC), College of Medicine, King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia.
| | | | | | - Fida Almuhawas
- King Abdullah Ear Specialist Center (KAESC), King Saud University Medical City (KSUMC), College of Medicine, King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), King Saud University Medical City (KSUMC), College of Medicine, King Saud University, P.O. Box: 245, 11411, Riyadh, Saudi Arabia
| |
Collapse
|
11
|
Tóth TF, Németh A, Bakó P, Révész P, Gerlinger I, Szanyi I. Matching the pitch perception of the cochlear implanted ear with the contralateral ear in patients with single-sided deafness: a novel approach. Eur Arch Otorhinolaryngol 2023; 280:4851-4859. [PMID: 37133499 PMCID: PMC10562495 DOI: 10.1007/s00405-023-08002-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/26/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Single-sided deaf patients following cochlear implantation often compare the sound quality of their implanted ear with normal hearing. The interaural differences can result in dissatisfaction with speech comprehension and reduced time of usage of the speech processor; hence, prolonging auditory adaptation time. The proposed calibration method presented in this study demonstrates how the frequency distribution of the cochlear implant can be set to adequately approximate the pitch perception of the contralateral normal hearing ear towards improving speech intelligibility in a noisy environment. METHODS In 12 postlingual single-sided deaf patients, subjective interaural pitch-matching was carried out to determine new central frequencies for the reallocation of the frequency bands of their speech processor (CP910, CP950 or CP1000, Cochlear, Australia). The patients were asked to compare the pitch of the tones presented to their normal hearing ear to the pitch of individual channels of their cochlear implant (CI522 or CI622, Cochlear, Australia). A third-degree polynomial curve was fit to the acquired matching frequencies to create the new frequency allocation table. Audiological measurements (free-field aided thresholds, speech reception thresholds, and monosyllabic word recognition score) in noise, together with a Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire (short version of the original SSQ) results were evaluated prior to the pitch-matching procedure, and again, 2 weeks later. RESULTS The free-field aided thresholds of the patients showed no greater shift than ± 5 dB following the procedure; however, their monosyllabic word recognition score in noise improved significantly (mean - 9.58%, SD 4.98%, matched pairs t test comparison: p < 0.001). The results of the SSQ12 questionnaire also showed significant improvement in speech intelligibility, sound localization, and sound quality (mean 0.96 points, SD 0.45 points, matched pairs t test comparison: p < 0.001). CONCLUSIONS Matching the pitch perception of the implanted cochlea with the sensation of the normal hearing contralateral ear, resulted in significant changes in the quality of hearing in patients with single-sided deafness. It is plausible the procedure can usher positive results in bimodal patients or following sequential bilateral cochlear implantation.
Collapse
Affiliation(s)
- Tamás Ferenc Tóth
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary.
| | - Adrienne Németh
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Péter Bakó
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Péter Révész
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - Imre Gerlinger
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| | - István Szanyi
- Department of Otorhinolaryngology and Head Neck Surgery, Medical School, University of Pécs, 2. Munkácsy M. Str., Pécs, 7621, Hungary
| |
Collapse
|
12
|
Gatto A, Tofanelli M, Costariol L, Rizzo S, Borsetto D, Gardenal N, Uderzo F, Boscolo-Rizzo P, Tirelli G. Otological Planning Software-OTOPLAN: A Narrative Literature Review. Audiol Res 2023; 13:791-801. [PMID: 37887851 PMCID: PMC10603892 DOI: 10.3390/audiolres13050070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
The cochlear implant (CI) is a widely accepted option in patients with severe to profound hearing loss receiving limited benefit from traditional hearing aids. CI surgery uses a default setting for frequency allocation aiming to reproduce tonotopicity, thus mimicking the normal cochlea. One emerging instrument that may substantially help the surgeon before, during, and after the surgery is a surgical planning software product developed in collaboration by CASCINATION AG (Bern, Switzerland) and MED-EL (Innsbruck Austria). The aim of this narrative review is to present an overview of the main features of this otological planning software, called OTOPLAN®. The literature was searched on the PubMed and Web of Science databases. The search terms used were "OTOPLAN", "cochlear planning software" "three-dimensional imaging", "3D segmentation", and "cochlear implant" combined into different queries. This strategy yielded 52 publications, and a total of 31 studies were included. The review of the literature revealed that OTOPLAN is a useful tool for otologists and audiologists as it improves preoperative surgical planning both in adults and in children, guides the intraoperative procedure and allows postoperative evaluation of the CI.
Collapse
Affiliation(s)
- Annalisa Gatto
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Ludovica Costariol
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Serena Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Daniele Borsetto
- Department of ENT, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Nicoletta Gardenal
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Francesco Uderzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy; (A.G.); (N.G.); (G.T.)
| |
Collapse
|
13
|
Yoshimura H, Watanabe K, Nishio SY, Takumi Y, Usami SI. Determining optimal cochlear implant electrode array with OTOPLAN. Acta Otolaryngol 2023; 143:748-752. [PMID: 37737708 DOI: 10.1080/00016489.2023.2256790] [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] [Received: 07/21/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND To achieve better speech performance following cochlear implantation (CI), measuring the patient's cochlear duct length (CDL) and determining the appropriate length of the CI array are important. OBJECTIVE To investigate the CDL in CI patients after using the OTOPLAN software preoperatively and compare the results of angular insertion depth (AID) estimation by OTOPLAN and postoperative radiography. MATERIALS AND METHODS The study included 105 Japanese CI patients with normal cochleae. We measured the CDL using OTOPLAN and the position of the tip channel of the electrode for each selected electrode array, and estimated the AID using the software. RESULTS The mean CDL was 35.1 ± 1.6 mm. Preoperatively, the mean estimated AID was 580.3 ± 57.8°. Postoperative radiography revealed a mean AID of 583.0 ± 56.7°, demonstrating a strong linear correlation between the two measurements (R2 = 0.635). CONCLUSION AND SIGNIFICANCE Our findings revealed that CDL varies widely, which is consistent with previous studies. To achieve better speech perception, surgeons should select the appropriate length of CI electrode array based on the individual's CDL. Preoperative measurement of each CDL by OTOPLAN, which is clinically feasible and comparable to postoperative evaluation, can be used to ensure selection of the appropriate electrode array length.
Collapse
Affiliation(s)
- Hidekane Yoshimura
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kizuki Watanabe
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yutaka Takumi
- Department of Otorhinolaryngology - Head and Neck Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan
| |
Collapse
|
14
|
Távora-Vieira D, Voola M, Kuthubutheen J, Friedland P, Gibson D, Acharya A. Evaluation of the Performance of OTOPLAN-Based Cochlear Implant Electrode Array Selection: A Retrospective Study. J Pers Med 2023; 13:1276. [PMID: 37623526 PMCID: PMC10455663 DOI: 10.3390/jpm13081276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
Otoplan is a surgical planning software designed to assist with cochlear implant surgery. One of its outputs is a recommendation of electrode array type based on imaging parameters. In this retrospective study, we evaluated the differences in auditory outcomes between patients who were implanted with arrays corresponding to those recommended by the Otoplan software versus those in which the array selection differed from the Otoplan recommendation. Pre-operative CT images from 114 patients were imported into the software, and array recommendations were generated. These were compared to the arrays which had actually been implanted during surgery, both in terms of array type and length. As recommended, 47% of patients received the same array, 34% received a shorter array, and 18% received a longer array. For reasons relating to structure and hearing preservation, 83% received the more flexible arrays. Those who received stiffer arrays had cochlear malformations or ossification. A negative, although non-statistically significant correlation was observed between the CNC scores at 12 months and the absolute value of the difference between recommended array and implanted array. In conclusion, clinicians may be slightly biased toward shorter electrode arrays due to their perceived greater ability to achieve full insertion. Using 3D imaging during the pre-operative planning may improve clinicians' confidence to implant longer electrode arrays, where appropriate, to achieve optimum hearing outcomes.
Collapse
Affiliation(s)
- Dayse Távora-Vieira
- Fiona Stanley Fremantle Hospitals Group, Perth, WA 6150, Australia
- Medical School, Division of Surgery, The University of Western Australia, Perth, WA 6010, Australia
- Faculty of Health Sciences, School of Allied Health, Curtin University, Perth, WA 6102, Australia
| | - Marcus Voola
- Fiona Stanley Fremantle Hospitals Group, Perth, WA 6150, Australia
- Medical School, Division of Surgery, The University of Western Australia, Perth, WA 6010, Australia
| | - Jafri Kuthubutheen
- Fiona Stanley Fremantle Hospitals Group, Perth, WA 6150, Australia
- Medical School, Division of Surgery, The University of Western Australia, Perth, WA 6010, Australia
- Sir Charles Gairdner Hospital, Perth, WA 6009, Australia
| | - Peter Friedland
- Medical School, Division of Surgery, The University of Western Australia, Perth, WA 6010, Australia
- Sir Charles Gairdner Hospital, Perth, WA 6009, Australia
| | - Daren Gibson
- Fiona Stanley Fremantle Hospitals Group, Perth, WA 6150, Australia
| | - Aanand Acharya
- Fiona Stanley Fremantle Hospitals Group, Perth, WA 6150, Australia
| |
Collapse
|
15
|
Thomas JP, Klein H, Haubitz I, Dazert S, Völter C. Intra- and Interrater Reliability of CT- versus MRI-Based Cochlear Duct Length Measurement in Pediatric Cochlear Implant Candidates and Its Impact on Personalized Electrode Array Selection. J Pers Med 2023; 13:jpm13040633. [PMID: 37109019 PMCID: PMC10142378 DOI: 10.3390/jpm13040633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
Background: Radiological high-resolution computed tomography-based evaluation of cochlear implant candidates’ cochlear duct length (CDL) has become the method of choice for electrode array selection. The aim of the present study was to evaluate if MRI-based data match CT-based data and if this impacts on electrode array choice. Methods: Participants were 39 children. CDL, length at two turns, diameters, and height of the cochlea were determined via CT and MRI by three raters using tablet-based otosurgical planning software. Personalized electrode array length, angular insertion depth (AID), intra- and interrater differences, and reliability were calculated. Results: Mean intrarater difference of CT- versus MRI-based CDL was 0.528 ± 0.483 mm without significant differences. Individual length at two turns differed between 28.0 mm and 36.6 mm. Intrarater reliability between CT versus MRI measurements was high (intra-class correlation coefficient (ICC): 0.929–0.938). Selection of the optimal electrode array based on CT and MRI matched in 90.1% of cases. Mean AID was 629.5° based on the CT and 634.6° based on the MRI; this is not a significant difference. ICC of the mean interrater reliability was 0.887 for the CT-based evaluation and 0.82 for the MRI-based evaluation. Conclusion: MRI-based CDL measurement shows a low intrarater difference and a high interrater reliability and is therefore suitable for personalized electrode array selection.
Collapse
Affiliation(s)
- Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Johannes Hospital, Cath. St. Paulus Society, Academic Teaching Hospital of the University of Münster, Johannesstr. 9-17, 44137 Dortmund, Germany
| | - Hannah Klein
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787 Bochum, Germany
| | - Imme Haubitz
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787 Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787 Bochum, Germany
| | - Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787 Bochum, Germany
| |
Collapse
|
16
|
Dutt SN, Gaur SK, Vadlamani S, Nandikur S. Evolving a Radiological Protocol for Cochlear Duct Length Measurement: Three Audit Cycles. Indian J Otolaryngol Head Neck Surg 2022; 74:3998-4006. [PMID: 36742472 PMCID: PMC9895517 DOI: 10.1007/s12070-021-02774-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
To develop an accurate protocol for measuring the Cochlear Duct Length (CDL) by using Multi Detector Computerized Tomography (MDCT) imaging of the temporal bones and thereby make the appropriate choice of electrode for cochlear implantation. 79 MED-EL® Cochlear implantees were divided into three cohorts in chronological order of their implantation. CDL was calculated from MDCT images and correlated with the CDL calculated using the existing Jolly's formula. Results of the CDL measured by unfurling the cochlea correlated well with the existing formula. In addition to CDL measurement, measuring diameter of each turn, especially the apical turn, helped in choosing the appropriate electrode for complete cochlear coverage. Having dedicated radiographers and neuro-radiologists can avoid inter-observer variations in CDL measurements. Measuring the CDL and the diameter of each turn helps in choosing an appropriate electrode thus minimizing intra-operative difficulties and achieving complete safe insertion.
Collapse
Affiliation(s)
- Sunil Narayan Dutt
- Department of Otorhinolaryngology, Head and Neck Surgery, Apollo Hospitals, 154/11, Bannerghatta Road, Opposite IIM, Bangalore, 560076 India
| | - Sumit Kumar Gaur
- Department of Otorhinolaryngology, Head and Neck Surgery, Apollo Hospitals, 154/11, Bannerghatta Road, Opposite IIM, Bangalore, 560076 India
| | - Swathi Vadlamani
- Department of Otorhinolaryngology, Head and Neck Surgery, Apollo Hospitals, 154/11, Bannerghatta Road, Opposite IIM, Bangalore, 560076 India
| | | |
Collapse
|
17
|
Alshalan A, Abdelsamad Y, Assiri M, Alsanosi A. Cochlear Implantation: The Variation in Cochlear Height. EAR, NOSE & THROAT JOURNAL 2022:1455613221134860. [PMID: 36251258 DOI: 10.1177/01455613221134860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to identify the association between different cochlear metrics, including the basal turn diameter (A-value), the basal turn width (B-value), and the height of the cochlea (H-value). We also reported an association between H-value and hearing outcomes with cochlear implants (CI). This is a retrospective study that included all patients who underwent CI procedures between 2012 and 2018 at a tertiary center and have; preoperative high-resolution computed tomography (CT), normal cochlea, postoperative follow-up duration of at least 2 years, scores of the category auditory performance II (CAP-II), and speech intelligibility rating (SIR) scales. A total of 65 ears implanted with CI in 46 patients (24 boys and 20 girls; mean age of 7 (±10) years) fulfilled the inclusion criteria. We found significant positive correlations between A vs B, A vs H, and B vs H (P-value = 0.008, 0.018, and 0.0039, respectively). We also found a significant positive relationship between A, B, and H values and cochlear duct length (CDL) (P-value < 0.0001, 0.008, and 0.018, respectively). Finally, the H-value was significantly correlated with the SIR (P-value = 0.027). However, its correlation with the CAP score was not statistically significant (P-value = 0.62). Cochlear height significantly correlated with CDL and the other cochlear parameters. The variation in cochlear height can also affect speech outcomes in patients undergoing CI. Therefore, the H-value together with the other cochlear metrics should be adequately assessed preoperatively in CI patients.
Collapse
Affiliation(s)
- Afrah Alshalan
- Department of Otolaryngology, Neurotology & Lateral Skull Base Surgery, King Abdullah Ear Specialist Center (KAESC), King Saud University, Riyadh, Saudi Arabia
| | | | - Majed Assiri
- Department of Otolaryngology, Neurotology & Lateral Skull Base Surgery, King Abdullah Ear Specialist Center (KAESC), King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
18
|
Grueninger I, Lippl L, Canis M, Simon F, Spiro JE, Spiegel JL, Hempel JM, Müller J, Volgger V. Anatomical Variations of the Epitympanum and the Usable Space for Middle Ear Implants Analyzed With CT-assisted Imaging Using a Tablet-based Software. Otol Neurotol 2022; 43:e454-e460. [PMID: 35213480 DOI: 10.1097/mao.0000000000003486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate interindividual anatomical variations of the epitympanum and the usable space for implantation of active middle ear implants (AMEI) as well as the usefulness of a tablet-based software to assess individual anatomy on computed tomography (CT) scans. PATIENTS CT scans of 126 patients, scheduled for cochlea implantation (50.8% men; 0.6-90.0 yr) without middle ear malformations or previous middle ear surgery and with slice thickness ≤0.7 mm were analyzed. MAIN OUTCOME MEASURES Since no standardized measurements to assess the size of the epitympanum are available, relevant distances were defined according to anatomical landmarks. Three independent raters measured these distances using a tablet-based software. Interrater correlation was computed to evaluate the quality of the measurement process. Descriptive data were analyzed for validation and for evaluation of interindividual anatomical variations. Influence of age and sex on the taken measurements was assessed. RESULTS No relevant correlation between age or sex and the anatomy of the epitympanum was found. Interrater correlation ranged from Spearman's ρ = 0.3-0.9 and there were significant differences between individual rater results for various combinations. Descriptive data revealed high interindividual anatomical variance of the epitympanum, especially regarding the distance between incus and skull base. CONCLUSION The reported descriptive data regarding the anatomy of the epitympanum emphasizes the importance of preoperative planning, especially since the height of the epitympanum showed great interindividual variance potentially limiting implantation of AMEIs. The herein used tablet-based software seems to be convenient for preoperative assessment of individual anatomy in the hand of otosurgeons.
Collapse
Affiliation(s)
- Ivo Grueninger
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Lisa Lippl
- MED-EL Medical Electronics GmbH, Innsbruck, Austria
| | - Martin Canis
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Florian Simon
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Judith E Spiro
- Department of Radiology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Jennifer L Spiegel
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - John Martin Hempel
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Joachim Müller
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| | - Veronika Volgger
- Department of Otorhinolaryngology, University Hospital, Ludwig Maximilian University Munich, Germany
| |
Collapse
|
19
|
Aljazeeri I, Hamed N, Abdelsamad Y, Sharif T, Al-Momani M, Hagr A. Anatomy-Based Frequency Allocation in Cochlear Implantation: The Importance of Cochlear Coverage. Laryngoscope 2021; 132:2224-2231. [PMID: 34967457 DOI: 10.1002/lary.30004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aimed to compare the predicted anatomy-based frequency allocation of cochlear implant electrodes with the default standard frequencies. STUDY DESIGN Retrospective study. METHODS A retrospective analysis was performed using computed tomography (CT) images of patients who received cochlear implants at a tertiary referral center. Patients were excluded if they had any congenital or acquired cochlear anatomical anomalies. The CT images of the patients were uploaded to the surgical planning software. Two independent reviewers allocated the anatomical parameters of the cochlea. The software then used these parameters to calculate the frequency allocation for each electrode according to the type of electrode and the length of the organ of Corti (OC) in each patient. These anatomy-based frequency allocations were compared with the default frequency settings. MAIN OUTCOME MEASURE Frequency-to-place mismatch in semitones. RESULTS A total of 169 implanted ears in 102 patients were included in this study. The readings of the two reviewers were homogenous, with a Cronbach's alpha of 0.98. The mean anatomy-based frequency allocation was 487.3 ± 202.9 Hz in electrode 1; 9,298.6 ± 490.6 Hz in electrode 12. The anatomy-based frequency allocations were found to be significantly higher than the frequencies of the default frequencies for each corresponding electrode (one-sample t-test, P < .001). The frequency-to-place mismatch was negatively correlated with cochlear coverage and positively correlated with the cochlear duct length (Pearson correlation > 0.65, P < .003). CONCLUSIONS The anatomy-based frequency allocation of each electrode is significantly different from the default frequency setting. This frequency-to-place mismatch was affected mainly by the cochlear coverage. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
Collapse
Affiliation(s)
- Isra Aljazeeri
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia.,Aljaber Ophthalmology and Otolaryngology Specialized Hospital, Ministry of Health, Ahsa, Saudi Arabia
| | - Nezar Hamed
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| | | | - Tahir Sharif
- Research Department, MED-EL GmbH, Riyadh, Saudi Arabia
| | - Murad Al-Momani
- ENT Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
20
|
Taeger J, Müller-Graff FT, Ilgen L, Schendzielorz P, Hagen R, Neun T, Rak K. Cochlear Duct Length Measurements in Computed Tomography and Magnetic Resonance Imaging Using Newly Developed Techniques. OTO Open 2021; 5:2473974X211045312. [PMID: 34595367 PMCID: PMC8477698 DOI: 10.1177/2473974x211045312] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT). Study Design Retrospective data analyses of 42 cochleae. Setting Tertiary care medical center. Methods Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2-turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2-turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method. Results CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P < .001) but not by ECA. Similar 2-turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P < .001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P < .001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28-mm CDL). Conclusion In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation-free cochlear implantation could be established.
Collapse
Affiliation(s)
- Johannes Taeger
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Franz Tassilo Müller-Graff
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Lukas Ilgen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Phillip Schendzielorz
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Tilman Neun
- Department of Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| |
Collapse
|
21
|
CT imaging-based approaches to cochlear duct length estimation-a human temporal bone study. Eur Radiol 2021; 32:1014-1023. [PMID: 34463797 PMCID: PMC8794899 DOI: 10.1007/s00330-021-08189-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 01/12/2023]
Abstract
Objectives Knowledge about cochlear duct length (CDL) may assist electrode choice in cochlear implantation (CI). However, no gold standard for clinical applicable estimation of CDL exists. The aim of this study is (1) to determine the most reliable radiological imaging method and imaging processing software for measuring CDL from clinical routine imaging and (2) to accurately predict the insertion depth of the CI electrode. Methods Twenty human temporal bones were examined using different sectional imaging techniques (high-resolution computed tomography [HRCT] and cone beam computed tomography [CBCT]). CDL was measured using three methods: length estimation using (1) a dedicated preclinical 3D reconstruction software, (2) the established A-value method, and (3) a clinically approved otosurgical planning software. Temporal bones were implanted with a 31.5-mm CI electrode and measurements were compared to a reference based on the CI electrode insertion angle measured by radiographs in Stenvers projection (CDLreference). Results A mean cochlear coverage of 74% (SD 7.4%) was found. The CDLreference showed significant differences to each other method (p < 0.001). The strongest correlation to the CDLreference was found for the otosurgical planning software-based method obtained from HRCT (CDLSW-HRCT; r = 0.87, p < 0.001) and from CBCT (CDLSW-CBCT; r = 0.76, p < 0.001). Overall, CDL was underestimated by each applied method. The inter-rater reliability was fair for the CDL estimation based on 3D reconstruction from CBCT (CDL3D-CBCT; intra-class correlation coefficient [ICC] = 0.43), good for CDL estimation based on 3D reconstruction from HRCT (CDL3D-HRCT; ICC = 0.71), poor for CDL estimation based on the A-value method from HRCT (CDLA-HRCT; ICC = 0.29), and excellent for CDL estimation based on the A-value method from CBCT (CDLA-CBCT; ICC = 0.87) as well as for the CDLSW-HRCT (ICC = 0.94), CDLSW-CBCT (ICC = 0.94) and CDLreference (ICC = 0.87). Conclusions All approaches would have led to an electrode choice of rather too short electrodes. Concerning treatment decisions based on CDL measurements, the otosurgical planning software-based method has to be recommended. The best inter-rater reliability was found for CDLA-CBCT, for CDLSW-HRCT, for CDLSW-CBCT, and for CDLreference. Key Points • Clinically applicable calculations using high-resolution CT and cone beam CT underestimate the cochlear size. • Ten percent of cochlear duct length need to be added to current calculations in order to predict the postoperative CI electrode position. • The clinically approved otosurgical planning software-based method software is the most suitable to estimate the cochlear duct length and shows an excellent inter-rater reliability.
Collapse
|
22
|
Müller-Graff FT, Ilgen L, Schendzielorz P, Voelker J, Taeger J, Kurz A, Hagen R, Neun T, Rak K. Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation. Eur Arch Otorhinolaryngol 2021; 279:2309-2319. [PMID: 34101009 PMCID: PMC8986679 DOI: 10.1007/s00405-021-06924-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/29/2021] [Indexed: 11/28/2022]
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.
Collapse
Affiliation(s)
- Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Lukas Ilgen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Philipp Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Johannes Taeger
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany
| | - Tilmann Neun
- Insitute for Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Bavaria, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany.
| |
Collapse
|
23
|
Spiegel JL, Polterauer D, Hempel JM, Canis M, Spiro JE, Müller J. Variation of the cochlear anatomy and cochlea duct length: analysis with a new tablet-based software. Eur Arch Otorhinolaryngol 2021; 279:1851-1861. [PMID: 34050805 PMCID: PMC8930796 DOI: 10.1007/s00405-021-06889-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/17/2021] [Indexed: 01/06/2023]
Abstract
Purpose In cochlear implantation, thorough preoperative planning together with measurement of the cochlear duct length (CDL) assists in choosing the correct electrode length. For measuring the CDL, different techniques have been introduced in the past century along with the then available technology. A tablet-based software offers an easy and intuitive way to visualize and analyze the anatomy of the temporal bone, its proportions and measure the CDL. Therefore, we investigated the calculation technique of the CDL via a tablet-based software on our own cohort retrospectively. Methods One hundred and eight preoperative computed tomography scans of the temporal bone (slice thickness < 0.7 mm) of already implanted FLEX28™ and FLEXSOFT™ patients were found eligible for analysis with the OTOPLAN software. Measurements were performed by two trained investigators independently. CDL, angular insertion depth (AID), and cochlear coverage were calculated and compared between groups of electrode types, sex, sides, and age. Results Mean CDL was 36.2 ± 1.8 mm with significant differences between sex (female: 35.8 ± 0.3 mm; male: 36.5 ± 0.2 mm; p = 0.037), but none concerning side or age. Differences in mean AID (FLEX28: 525.4 ± 46.4°; FLEXSOFT: 615.4 ± 47.6°), and cochlear coverage (FLEX28: 63.9 ± 5.6%; FLEXSOFT: 75.8 ± 4.3%) were significant (p < 0.001). Conclusion A broad range of CDL was observed with significant larger values in male, but no significant differences concerning side or age. Almost every cochlea was measured longer than 31.0 mm. Preoperative assessment aids in prevention of complications (incomplete insertion, kinking, tipfoldover), attempt of atraumatic insertion, and addressing individual necessities (hearing preservation, cochlear malformation). The preferred AID of 720° (two turns of the cochlea) was never reached, opening the discussion for the requirement of longer CI-electrodes versus a debatable audiological benefit for the patient in his/her everyday life. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06889-0.
Collapse
Affiliation(s)
- Jennifer L Spiegel
- Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
| | - Daniel Polterauer
- Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - John-Martin Hempel
- Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Judith E Spiro
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Joachim Müller
- Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany
| |
Collapse
|
24
|
Khurayzi T, Almuhawas F, Alsanosi A, Abdelsamad Y, Doyle Ú, Dhanasingh A. A novel cochlear measurement that predicts inner-ear malformation. Sci Rep 2021; 11:7339. [PMID: 33795738 PMCID: PMC8016924 DOI: 10.1038/s41598-021-86741-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022] Open
Abstract
The A-value used in cochlear duct length (CDL) estimation does not take malformed cochleae into consideration. The objective was to determine the A-value reported in the literature, to assess the accuracy of the A-value measurement and to evaluate a novel cochlear measurement in distinguishing malformed cochlea. High resolution Computer Tomography images in the oblique coronal plane/cochlear view of 74 human temporal bones were analyzed. The A-value and novel C-value measurement were evaluated as predictors of inner ear malformation type. The proximity of the facial nerve to the basal turn was evaluated subjectively. 26 publications report on the A-value; but they do not distinguish normal vs. malformed cochleae. The A-values of the normal cochleae compared to the cochleae with cochlear hypoplasia, incomplete partition (IP) type I, -type II, and -type III were significantly different. The A-value does not predict the C-value. The C-values of the normal cochleae compared to the cochleae with IP type I and IP type III were significantly different. The proximity of the facial nerve to the basal turn did not relate to the type of malformation. The A-value is different in normal vs. malformed cochleae. The novel C-value could be used to predict malformed anatomy, although it does not distinguish all malformation types.
Collapse
Affiliation(s)
- Tawfiq Khurayzi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, 11411, Saudi Arabia. .,King Fahad Central Hospital, Ministry of Health, Jizan, 82666, Saudi Arabia.
| | - Fida Almuhawas
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, 11411, Saudi Arabia
| | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, 11411, Saudi Arabia
| | | | - Úna Doyle
- Research and Development Department, MED-EL GmbH, Innsbruck, Austria
| | - Anandhan Dhanasingh
- Research and Development Department, MED-EL GmbH, Innsbruck, Austria.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
25
|
Atalay B, Eser MB, Kalcioglu MT, Ankarali H. Comprehensive Analysis of Factors Affecting Cochlear Size: A Systematic Review and Meta-analysis. Laryngoscope 2021; 132:188-197. [PMID: 33764541 DOI: 10.1002/lary.29532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine the cochlea's average size in humans and evaluate the relationships between certain covariates and cochlear size. METHODS A systematic search on articles on cochlear size and published in English was conducted using Cochrane, PubMed, Web of Science, and Scopus databases up to September 15, 2020. Data were pooled using random-effects with three models. The effect of demographic, clinical, and measurement-related parameters was specifically analyzed. Meta-regression and subgroup analyses were conducted. The overall effect estimation was made for outcomes. RESULTS The meta-analysis included 4,708 cochleae from 56 studies. The overall length of the organ of Corti was 32.94 mm (95% confidence interval [CI]: 32.51-33.38). The first and second models revealed that age, gender, country, continent, measurement method (direct, indirect), measured structure ("A" value, cochlear lateral wall), origin (in vivo, in vitro), and type (histology specimens, plastic casts, imaging) of the cochlear material did not affect the cochlear size. However, study populations (general population, patients with a cochlear implant, and patients with congenital sensorineural hearing loss [CSNHL]) were found to affect the outcomes. Compared to the other populations, patients with CSNHL had shorter cochleae. Therefore, we developed a third model and found that the general population and patients with cochlear implants did not differ in cochlear size. CONCLUSION This meta-analysis investigated the factors that could affect the cochlear size and found that patients with CSNHL had significantly shorter cochleae, whereas other covariates had no significant effect. Laryngoscope, 2021.
Collapse
Affiliation(s)
- Basak Atalay
- Faculty of Medicine, Department of Radiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet Bilgin Eser
- Faculty of Medicine, Department of Radiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mahmut Tayyar Kalcioglu
- Faculty of Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Handan Ankarali
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University, Istanbul, Turkey
| |
Collapse
|