New hybrid multiplanar cone beam computed tomography-laser-fluoroscopic-guided approach in cochlear implant surgery.
CBCT
Cochlea implant
Hybrid laser-fluoroscopic
Intraoperative imaging
Journal
International journal of computer assisted radiology and surgery
ISSN: 1861-6429
Titre abrégé: Int J Comput Assist Radiol Surg
Pays: Germany
ID NLM: 101499225
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
05
06
2021
accepted:
10
06
2022
pubmed:
12
7
2022
medline:
15
9
2022
entrez:
11
7
2022
Statut:
ppublish
Résumé
Cochlea implant surgery with proper positioning of the cochlear electrode can be challenging. Intraoperative real-time hybrid laser-fluoroscopic-guided navigation based on a multiplanar cone beam computed tomography (CBCT) dataset opens up the opportunity to immediate radiological control of primary electrode misalignments and offering new insights into the cochlea electrode insertion routes and favorable cochlear implant-insertion angle. In this retrospective study, 50 cases (29 males, 18 females) of conventional electrode implantation (without intraoperative image control; group A) and nine cases (7 males, 2 females) of CBCT-laser-fluoroscopic-guided surgery (group B) were included in the present study. CBCT-laser-guided surgery under real-time fluoroscopic control was conducted using an intraoperative C-arm CBCT. All patients received preoperative cross-sectional imaging (CT and MRI), in which cochlear malformation could be excluded. Postoperatively, we looked for electrode misplacements. In group A, electrode misalignment was detected postoperatively in 14 of 50 cases (28.0%). In group B, primary electrode misalignment was detected intraoperatively in two patients (22.2%). In both patients, the misalignments were corrected in the same session. The comparison of cochlear insertion angles showed significant differences. Group A: 47.5 ± 2.6° (actual conventional surgery) vs 17.6 ± 2.8° (theoretical CBCT-laser-fluoroscopic-guided surgery) P < 0.001. Group A vs group B: 47.5 ± 2.6° (actual conventional surgery; Group A) vs 17.9 ± 2.5° (actual CBCT-laser-fluoroscopic-guided surgery; Group B) P < 0.001. We consider that an intraoperative hybrid CBCT-laser-fluoroscopic-controlled approach in cochlear implant surgery using a C-arm CT can be beneficial, because electrode misalignments can be reduced and if it does occur, remedied in the same surgical session.
Identifiants
pubmed: 35816271
doi: 10.1007/s11548-022-02703-2
pii: 10.1007/s11548-022-02703-2
pmc: PMC9467958
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1837-1843Informations de copyright
© 2022. The Author(s).
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