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Fluoroscopy guided electrode-array insertion for cochlear implantation with straight electrode-arrays: a valuable tool in most cases
- Source :
- European Archives of Oto-Rhino-Laryngology, European Archives of Oto-Rhino-Laryngology, Springer Verlag, 2021, 278 (4), pp.965-975. ⟨10.1007/s00405-020-06151-z⟩, European Archives of Oto-Rhino-Laryngology, 2021, 278 (4), pp.965-975. ⟨10.1007/s00405-020-06151-z⟩
- Publication Year :
- 2021
- Publisher :
- HAL CCSD, 2021.
-
Abstract
- To highlight the advantages of real time fluoroscopy guided electrode-array (EA) insertion (FGI) during cochlear implants surgery. All surgical procedures were performed in a dedicated operating room equipped with a robotic C-arm cone beam device, allowing for intraoperative real time 2D FGI and postoperative 3D imaging. Only straight EAs were used. Patients were sorted out in three groups: ANAT, with anatomical concerns; HP, with residual hearing; NPR: patients with no particular reason for FGI. In all cases the angle of EA-insertion was measured. In the HP group pre and postoperative hearing were compared. The radiation delivered to the patient was recorded. Fifty-three cochlear implantation procedures were achieved under fluoroscopy in 50 patients from November 2015 to January 2020 (HP group: n = 10; ANAT group: n = 13; NPR group: n = 27). In the ANAT group, FGI proved to be helpful in 8 cases (61.5%), successfully guiding the surgeon during EA -insertion. On average, the angle of insertion was at 424° ± 55°. In the HP group, a controlled smooth EA-insertion was carried out in all cases but one. The targeted 360° angle of insertion was always reached. Hearing preservation was possible with an eventual average drop of 30 ± 1.5 dB. In the NPR group, FGI helped control the quality of insertion in all cases and appeared very informative in five (17.8%): one EA-misrouting, three stuck EAs, and one case with hidden electrodes out of the cochlea in revision surgery. Final 3D cone beam CT scan double-checked the EA position in all adults. The radiation dose was equivalent to a bit less than four digital subtract radiographs. The FGI is a very useful adjunct in cochlear implantation in all cases of expected surgical pitfalls, in patients with residual hearing, and even in case without preoperative particular reason, with low irradiation.
- Subjects :
- Adult
medicine.medical_specialty
Radiography
[SDV]Life Sciences [q-bio]
Straight electrode
03 medical and health sciences
0302 clinical medicine
Electrode array
Humans
Medicine
Fluoroscopy
In patient
030223 otorhinolaryngology
Cochlear implantation
ComputingMilieux_MISCELLANEOUS
Hearing preservation
medicine.diagnostic_test
business.industry
General Medicine
Cochlear Implantation
Cochlea
Electrodes, Implanted
Cochlear Implants
Otorhinolaryngology
030220 oncology & carcinogenesis
business
Nuclear medicine
Subjects
Details
- Language :
- English
- ISSN :
- 09374477 and 14344726
- Database :
- OpenAIRE
- Journal :
- European Archives of Oto-Rhino-Laryngology, European Archives of Oto-Rhino-Laryngology, Springer Verlag, 2021, 278 (4), pp.965-975. ⟨10.1007/s00405-020-06151-z⟩, European Archives of Oto-Rhino-Laryngology, 2021, 278 (4), pp.965-975. ⟨10.1007/s00405-020-06151-z⟩
- Accession number :
- edsair.doi.dedup.....7935bbece4b60841ede9ae4405adf3c0