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Karkas A, Boureille P, Laroche N, Vico L, Bergandi F, Marotte H. Imaging of the human cochlea using micro-computed tomography before and after cochlear implantation: comparison with cone-beam computed tomography. Eur Arch Otorhinolaryngol 2023; 280:3131-3140. [PMID: 36604323 DOI: 10.1007/s00405-022-07811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Analysis of cochlear structures and postoperative temporal bone (TB) imaging are gaining importance in the evaluation of cochlear implantation (CI°). Our aims were to explore the microarchitecture of human cochlea using micro-computed tomography (μCT), analyze electrode's placement inside cochlea after CI°, and compare pre-/post-implantation μCT scans with cone-beam CT (CBCT) scans of same TBs. METHODS Cadaveric TBs were scanned using μCT and CBCT then underwent CI° using straight electrodes. Thereafter, they underwent again μCT and CBCT-imaging. RESULTS Ten TBs were studied. μCT allowed visualization of scala tympani, scala vestibuli, basilar membrane, osseous spiral lamina, crista fenestrae, and spiral ligament. CBCT showed same structures except spiral ligament and crista fenestrae. After CI°, μCT and CBCT displayed the scalar location and course of electrode array within the cochlea. There were 7 cases of atraumatic electrode insertion and 3 cases of insertion trauma: basilar membrane elevation, electrode foldover with limited migration into scala vestibuli, and electrode kinking with limited migration into scala vestibuli. Insertion trauma was not correlated with cochlea's size or crista's maximal height but with round window membrane diameter. Resolution of μCT was higher than CBCT but electrode artifacts were similar. CONCLUSIONS μCT was accurate in visualizing cochlear structures, and course and scalar position of electrode array inside cochlea with any possible trauma to cochlea or array. CBCT offers a good alternative to μCT in clinical practice for cochlear imaging and evaluation of CI°, with lower radiation and higher resolution than multi-slice CT. Difficulties related to non-traumatic CI° are multifactorial.
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Affiliation(s)
- Alexandre Karkas
- Service Oto-Rhino-Laryngologie, Division of Otology/Neurotology, Hôpital Nord, University Medical Center of Saint-Etienne, CHU Saint-Etienne, 42055, Saint-Etienne, France. .,Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France. .,Laboratory of Anatomy of Medical School Jacques Lisfranc, Saint-Etienne, France.
| | - Pierre Boureille
- Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France.,Division of Neuroradiology, University Medical Center of Saint-Etienne, Saint-Etienne, France
| | - Norbert Laroche
- Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France
| | - Laurence Vico
- Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France
| | - Florian Bergandi
- Laboratory of Anatomy of Medical School Jacques Lisfranc, Saint-Etienne, France
| | - Hubert Marotte
- Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France.,Department of Rheumatology, University Medical Center of Saint-Etienne, Saint-Etienne, France
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Patil DJ, More CB, Venkatesh R, Shah P. Insight in to the Awareness of CBCT as an Imaging Modality in the Diagnosis and Management of ENT Disorders: A Cross Sectional Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5283-5293. [PMID: 36742614 PMCID: PMC9895214 DOI: 10.1007/s12070-020-02209-w] [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: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023] Open
Abstract
The advent of Cone-beam computed tomography (CBCT), has revolutionized 3D imaging in dentistry. CBCT has enormous potential to be used as an alternative imaging modality by Otolaryngologists. But their knowledge regarding CBCT is limited. The study aims to evaluate the awareness of CBCT as an imaging modality among Ear, nose and Throat (ENT) practitioners. The validated questionnaire was sent by email and the participants were asked to fill the google form through the link provided to record the responses. The participants were asked to answer 25 multiple choice questions regarding the general information and practice related to CBCT imaging. Data was evaluated according to the descriptive statistics and the Chi-square test was used to determine the test of significance. The response rate for this study was 84.4%. The mean age of the participants was 44.9 ± 11.3. 69% of the respondents were academicians,14.2% had exclusive clinical practice, and 16.8% had both clinical and academic exposure. Among the study population, 76.8% had never advised CBCT in their practice. Only 10.3% of the study participants were aware of the potential of CBCT in ENT disorders. The mean knowledge, attitude and practice scores were very low regarding the applications of CBCT. Most of the study participants advised CBCT for maxillofacial fractures (78.1%) and was statistically significant p < 0.05. The knowledge about various advantages and clinical applications of CBCT among Otolaryngologists is limited. However, continuing medical education and inclusion in the medical curriculum will increase the scope and awareness about CBCT among ENT fraternity.
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Affiliation(s)
- Deepa Jatti Patil
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Chandramani B. More
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Rashmi Venkatesh
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
| | - Palak Shah
- Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat 391760 India
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Sismono F, Leblans M, Mancini L, Veneziano A, Zanini F, Dirckx J, Bernaerts A, de Foer B, Offeciers E, Zarowski A. 3D-localisation of cochlear implant electrode contacts in relation to anatomical structures from in vivo cone-beam computed tomography. Hear Res 2022; 426:108537. [DOI: 10.1016/j.heares.2022.108537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/18/2022] [Accepted: 05/23/2022] [Indexed: 12/11/2022]
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Liu M, Lin X, Tan Q, Han X. Evidence-Based Analysis of the Emergency Temporary Cardiac Pacing (Electrical Stimulation from Metal Wire Electrode). Bioinorg Chem Appl 2021; 2021:5677598. [PMID: 34484317 PMCID: PMC8413046 DOI: 10.1155/2021/5677598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 08/14/2021] [Indexed: 12/13/2022] Open
Abstract
The patient's Cr (creatinine), BUN (blood urea nitrogen), HBG (hemoglobin), VT (ventricular tachycardia), pacing frequency, puncture point, emergency to permanent pacing time, pacing current (mA), pacing threshold current (mA), and admission diagnosis data were collected. The data were subjected to frequency statistics, curve regression analysis, PLS regression analysis, adjustment analysis, chi-square test, ridge regression analysis, discriminant analysis, negative binomial regression analysis, Poisson regression analysis, and stepwise regression analysis. Some findings include the following: (1) Cr has a significant positive effect on HBG, and BUN has a significant negative effect on HBG. (2) VT has a negative correlation with age and a positive correlation with CK-MB and CK (creatinine kinase). (3) Myocarditis has a negative correlation with age and a significant positive correlation with CTnI (cardiac troponin I). (4) AST (aspartate transaminase) and ALT (alanine aminotransferase) have a significant positive impact on DDI (D-dimer), while CTnI has a significant negative impact on DDI. MYO (myoglobin) has no impact relationship to DDI. (5) ALT has a significant positive relationship with APTT (partial thromboplastin time). (6) Alb (albumin) and TBIL (total bilirubin) have a significant positive effect on PLT (platelet) count, while pro-BNP (B-type natriuretic peptide) and MYO have a significant negative effect on PLT. (7) CK has a significant positive effect on INR (international normalized ratio). (8) The relationship between sinus node dysfunction and VT significantly affect the pacing frequency (beats/minute). For third-degree atrioventricular block, different samples of sinus node dysfunction showed significant differences. (9) There is a significant positive correlation between pacing current (mA) and pacing threshold current (mA). (10) There was a significant positive correlation between perceived voltage (mV) and the time from emergency to permanent pacing. Admission diagnosis has a significant positive impact on the time from emergency to permanent pacing. The change (increase) in time from emergency to permanent pacing was 1.137-fold when an additional condition was diagnosed on admission.
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Affiliation(s)
- Meng Liu
- Emergency Department, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan, China
| | - Xuming Lin
- Electromyogram Department, Hunan Province Hospital of Chinese Medicine (The Second-Affiliate Hospital of Hunan University of Chiniese Medicine), Changsha 410005, China
| | - Qiaoyin Tan
- College of Teacher Education, Zhejiang Normal University, Jinhua 321004, Zhejiang, China
| | - Xiaotong Han
- Emergency Department, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan, China
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Feasibility of Cochlea High-frequency Ultrasound and Microcomputed Tomography Registration for Cochlear Computer-assisted Surgery: A Testbed. Otol Neurotol 2021; 42:e779-e787. [PMID: 33871251 DOI: 10.1097/mao.0000000000003091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION There remains no standard imaging method that allows computer-assisted surgery of the cochlea in real time. However, recent evidence suggests that high-frequency ultrasound (HFUS) could permit real-time visualization of cochlear architecture. Registration with an imaging modality that suffers neither attenuation nor conical deformation could reveal useful anatomical landmarks to surgeons. Our study aimed to address the feasibility of an automated three-dimensional (3D) HFUS/microCT registration, and to evaluate the identification of cochlear structures using 2D/3D HFUS and microCT. METHODS MicroCT, and 2D/3D 40 MHz US in B-mode were performed on ex vivo guinea pig cochlea. An automatic rigid registration algorithm was applied to segmented 3D images. This automatic registration was then compared to a reference method using manual annotated landmarks placed by two senior otologists. Inter- and intrarater reliabilities were evaluated using intraclass correlation coefficient (ICC) and the mean registration error was calculated. RESULTS 3D HFUS/microCT automatic registration was successful. Excellent levels of concordance were achieved with regards intra-rater reliability for both raters with micro-CT and US images (ICC ranging from 0.98 to 1, p < 0.001) and with regards inter-rater reliability (ICC ranging from 0.99 to 1, p < 0.001). The mean HFUS/microCT automated RE for both observers was 0.17 ± 0.03 mm [0.10-0.25]. Identification of the basilar membrane, modiolus, scala tympani, and scala vestibuli was possible with 2D/3D HFUS and micro-CT. CONCLUSIONS HFUS/microCT image registration is feasible. 2D/3D HFUS and microCT allow the visualization of cochlear structures. Many potential clinical applications are conceivable.
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Leso V, Fontana L, Ercolano ML, Romano R, Iavicoli I. Opportunities and challenging issues of nanomaterials in otological fields: an occupational health perspective. Nanomedicine (Lond) 2019; 14:2613-2629. [PMID: 31609676 DOI: 10.2217/nnm-2019-0114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Nanotechnology may offer innovative solutions to overcome the physiological and anatomical barriers that make the diagnosis and treatment of ear diseases an extremely challenging issue. However, despite the solutions provided by nano-applications, the still little-known toxicological behavior of nanomaterials raised scientific concerns regarding their biosafety for treated patients and exposed workers. Therefore, this review provides an overview on recent developments and upcoming opportunities in nanoscale otological applications, and critically assesses possible adverse effects of nanosized compounds on ear structures and hearing functionality. Although such preliminary data do not allow to draw definite strategies for the evaluation of nanomaterial ototoxicity, they can still be useful to improve scientific community and workforce awareness regarding possible nanomaterial adverse effects on ear.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Luca Fontana
- Department of Occupational & Environmental Medicine, Epidemiology & Hygiene, Italian Workers' Compensation Authority (INAIL), Via di Fontana Candida 1, 00040 Monte Porzio Catone, Rome, Italy
| | - Maria Luigia Ercolano
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Rosaria Romano
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131 Naples, Italy
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Intraoperative Evaluation of Cochlear Implant Electrodes Using Mobile Cone-Beam Computed Tomography. Otol Neurotol 2019; 40:177-183. [PMID: 30624399 DOI: 10.1097/mao.0000000000002097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the electrode status during cochlear implantation (CI) using mobile cone-beam CT (mCBCT). STUDY DESIGN Retrospective case review. SETTING Tertiary referral hospital. PATIENTS Fifty-seven patients (7 bilateral surgeries, 64 ears) who underwent CI and who received intraoperative mCBCT imaging. INTERVENTION CI and CBCT during surgery. MAIN OUTCOME MEASURE Electrode location and angular insertion depth determined by intraoperative mCBCT images. RESULTS There were six cases with cochlear malformation where intraoperative mCBCT was useful to confirm electrode location. Of 58 ears with a normal cochlear morphology, perimodiolar, straight, and mid-scalar electrodes were used in 30 (cochleostomy; 14 advance off-stylet technique cases), 27 (26 round window [RW] insertion, 1 extended round window [ERW] insertion), and 1 (RW insertion) ears, respectively. Complete scala-tympani (ST) insertion was achieved in 35 ears (14 cochleostomy, 21 RW or ERW insertion). The complete ST-insertion rate was significantly higher with RW or ERW insertion than that for cochleostomy insertion (p = 0.03), although cochleostomy insertion using the advanced off-stylet technique had a similar rate to RW or ERW insertion. The angular insertion depth values (average ± standard deviation) for perimodiolar electrodes (354.4 ± 29.44 degrees) were significantly smaller than those for Flex24 (464.8 ± 43.09 degrees) and Flex28 (518.2 ± 61.91 degrees) electrodes (p < 0.05). CONCLUSIONS Evaluation of CI electrodes using intraoperative mCBCT was comparable to that with fan-beam CT or c-arm-based CBCT. Considering the low radiation dose of mCBCT and its availability in any operation room, mCBCT is the better modality for evaluating cochlear implant electrode arrays.
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Assessing Cochlear Length Using Cone Beam Computed Tomography in Adults With Cochlear Implants. Otol Neurotol 2018; 39:e757-e764. [DOI: 10.1097/mao.0000000000001934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Fan X, Xia M, Wang Z, Zhang H, Liu C, Wang N, Hou L, Li C, Xu A. Comparison of electrode position between round window and cochleostomy inserting approaches among young children: a cone-beam computed tomography study. Acta Otolaryngol 2018; 138:815-821. [PMID: 29936898 DOI: 10.1080/00016489.2018.1478127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND As the two most commonly used approaches for cochlear implants (CIs), the round-window insertion (RWI) and cochleostomy are still controversial about which approach is optimal. The lack of visual observation methods makes it difficult to compare the electrode position between them. OBJECTIVES To evaluate and compare the electrode position between RWI and cochleostomy approaches for CI among young children. MATERIALS AND METHODS Twenty-four patients (16 male, 8 female) accepting CI and temporal cone-beam computed tomography (CBCT) scan post-operation in our hospital from January 2016 to July 2017 were analyzed retrospectively. Operative notes and images were used to identify the surgical technique. Mainly depending on the round-window exposure, 15 cochleae were performed with RWI and 11 performed with cochleostomy. RESULTS Mean age, 2.4 (range 0.8-7) years. The CBCT images showed that all the electrode arrays were located in scala tympani. There were no significantly statistical differences in the distance between electrode contacts and modiolus (EMI), intracochlear insertion length and the angle of electrode arrays at the insertion site of the cochlea. CONCLUSIONS AND SIGNIFICANCE Both approaches could insert electrodes into scala tympani satisfactorily. As electrodes and cochlear structures could be clearly visualized, CBCT can be applied to assess the electrode position reliably.
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Affiliation(s)
- Xintai Fan
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Ming Xia
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Zhe Wang
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Hui Zhang
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Chengcheng Liu
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Na Wang
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Lingxiao Hou
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Chen Li
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Anting Xu
- Department of Otorhinolaryngology & Head and Neck Surgery, The Second Hospital of Shandong University, Jinan, China
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Menegatti Pavan AL, Alves AFF, Giacomini G, Altemani JMC, Castilho AM, Lauria RA, da Silva VAR, Guimarães AC, de Pina DR. Cochlear implants: Insertion assessment by computed tomography. Am J Otolaryngol 2018; 39:431-435. [PMID: 29685378 DOI: 10.1016/j.amjoto.2018.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/10/2018] [Accepted: 04/14/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Imaging exams play a key role in cochlear implants with regard to both planning implantation before surgery and quality control after surgery. The ability to visualize the three-dimensional location of implanted electrodes is useful in clinical routines for assessing patient outcome. The aim of this study was to evaluate linear and angular insertion depth measurements of cochlear implants based on conventional computed tomography. METHODS Tools for linear and angular measurements of cochlear implants were used in computed tomography exams. The tools realized the insertion measurements in an image reconstruction of the CIs, based on image processing techniques. We comprehensively characterized two cochlear implant models while obviating possible changes that can be caused by different cochlea sizes by using the same human temporal bones to evaluate the implant models. RESULTS The tools used herein were able to differentiate the insertion measurements between two cochlear implant models widely used in clinical practice. We observed significant differences between both insertion measurements because of their different design and construction characteristics (p = 0.004 and 0.003 for linear and angular measurements, respectively; t-test). The presented methodology showed to be a good tool to calculate insertion depth measurements, since it is easy to perform, produces high-resolution images, and is able to depict all the landmarks, thus enabling measurement of the angular and linear insertion depth of the most apical electrode contacts. CONCLUSION The present study demonstrates practical and useful tools for evaluating cochlear implant electrodes in clinical practice. Further studies should measure preoperative and postoperative benefits in terms of speech recognition and evaluate the preservation of residual hearing in the implanted ear. Such studies can also determine correlations between surgical factors, electrode positions, and performance. In addition to refined surgical techniques, the precise evaluation of cochlear length and correct choice of cochlear implant characteristics can play an important role in postoperative outcomes.
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Affiliation(s)
- Ana Luiza Menegatti Pavan
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista (IBB-UNESP), Botucatu, São Paulo, Brazil
| | - Allan Felipe Fattori Alves
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista (IBB-UNESP), Botucatu, São Paulo, Brazil
| | - Guilherme Giacomini
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista (IBB-UNESP), Botucatu, São Paulo, Brazil
| | | | - Arthur Menino Castilho
- Hospital de Clínicas, Universidade Estadual de Campinas (HC-UNICAMP), Campinas, São Paulo, Brazil
| | - Raquel Andrade Lauria
- Hospital de Clínicas, Universidade Estadual de Campinas (HC-UNICAMP), Campinas, São Paulo, Brazil
| | | | | | - Diana Rodrigues de Pina
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (FMB-UNESP), Botucatu, São Paulo, Brazil.
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Abstract
Cochlear implants (CI) restore functional hearing in the majority of deaf patients. Despite the tremendous success of these devices, some limitations remain. The bottleneck for optimal electrical stimulation with CI is caused by the anatomical gap between the electrode array and the auditory neurons in the inner ear. As a consequence, current devices are limited through 1) low frequency resolution, hence sub-optimal sound quality and 2), large stimulation currents, hence high energy consumption (responsible for significant battery costs and for impeding the development of fully implantable systems). A recently completed, multinational and interdisciplinary project called NANOCI aimed at overcoming current limitations by creating a gapless interface between auditory nerve fibers and the cochlear implant electrode array. This ambitious goal was achieved in vivo by neurotrophin-induced attraction of neurites through an intracochlear gel-nanomatrix onto a modified nanoCI electrode array located in the scala tympani of deafened guinea pigs. Functionally, the gapless interface led to lower stimulation thresholds and a larger dynamic range in vivo, and to reduced stimulation energy requirement (up to fivefold) in an in vitro model using auditory neurons cultured on multi-electrode arrays. In conclusion, the NANOCI project yielded proof of concept that a gapless interface between auditory neurons and cochlear implant electrode arrays is feasible. These findings may be of relevance for the development of future CI systems with better sound quality and performance and lower energy consumption. The present overview/review paper summarizes the NANOCI project history and highlights achievements of the individual work packages.
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Diogo I, Walliczeck U, Taube J, Franke N, Teymoortash A, Werner J, Güldner C. Possibility of differentiation of cochlear electrodes in radiological measurements of the intracochlear and chorda-facial angle position. ACTA OTORHINOLARYNGOLOGICA ITALICA 2017; 36:310-316. [PMID: 27734984 PMCID: PMC5066467 DOI: 10.14639/0392-100x-878] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/13/2016] [Indexed: 11/23/2022]
Abstract
Due to an increasing number of cochlear implantations, quality control has become more important. In addition to intraoperative biophysical measurements, radiological imaging is another possibility. An upcoming technique regarding this is Cone Beam CT (CBCT). Sixty-five data sets (35 Nucleus Contour Advance–Cochlear; 30 Flex Soft–MedEl) of postoperative imaging by CBCT (Accu-I-tomo F17, Morita, Kyoto, Japan) underwent further evaluation. Insertion angle, height of the cochlea, distance of the electrode to the medial or lateral wall, angle between chorda tympani and facial nerve and the precise position of the electrode cable in the facial-chordal angle were determined. The typical difference between the perimodiolar and lateral course of the electrodes could also be shown in radiological measurements. This demonstrates the accuracy and advantage of CBCT in visualisation of small structures with fewer metal artifacts. Furthermore, in 75% of patients, the angle of the chorda and facial nerve could be visualised. Significant differences in dependence of the electrode type for the relation of them to the facial nerve could be seen. In conclusion, CBCT achieves reliable visualisation and detailed imaging-based measurements of the intracochlear position of different cochlea electrodes. Additionally, clinically known differences can be reproduced. Even visualisation of the position of the electrode in the chorda-facial angle is possible. Therefore, CBCT is a useful tool in intra- and postoperative control of cochlear implants.
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Affiliation(s)
- I Diogo
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - U Walliczeck
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - J Taube
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - N Franke
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - A Teymoortash
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - J Werner
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
| | - C Güldner
- University Department of ORL, Head and Neck Surgery; UKGM, Marburg, Germany
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Zou J, Lähelmä J, Arnisalo A, Pyykkö I. Clinically relevant human temporal bone measurements using novel high-resolution cone-beam CT. J Otol 2017; 12:9-17. [PMID: 29937832 PMCID: PMC6011811 DOI: 10.1016/j.joto.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/12/2017] [Accepted: 01/16/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To test the feasibility of measuring fine temporal bone structures using a newly established cone-beam computed tomography (CBCT) system. MATERIALS AND METHODS Six formalin-fixed human cadaver temporal bones were imaged using a high-resolution CBCT system that has 900 frames and copper + aluminum filtration. Fine temporal bone structures, including those of the facial nerve canal and vestibular structures, were identified and measured. RESULTS The fine structures of the middle ear, including the tympanic membrane, tendon of the tensor tympani, cochleariform process of the semicanal of the tensor tympani, pyramidal eminence, footplate of the stapes, full path of the facial nerve within the temporal bone, supralabyrinthine space, semicircular canals, pathway of the subarcuate canal, and full path of the vestibular aqueduct, were clearly demonstrated. The vestibular aqueduct has a midpoint width of 0.4 ± 0.0 mm and opercular width of 0.5 ± 0.1 mm (mean ± SD). The length of the internal acoustic meatus was 10.6 ± 1.2 mm (mean ± SD), and the diameter of the internal acoustic meatus was 3.7 ± 0.3 mm (mean ± SD). CONCLUSION This novel high-resolution CBCT system has potentially broad applications in the diagnosis of inner ear disease and in monitoring associated pathological changes, surgical planning, navigation for the ear surgery, and temporal bone training.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
| | | | - Antti Arnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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Zou J, Pyykkö I, Hyttinen J. Inner ear barriers to nanomedicine-augmented drug delivery and imaging. J Otol 2016; 11:165-177. [PMID: 29937826 PMCID: PMC6002620 DOI: 10.1016/j.joto.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 02/08/2023] Open
Abstract
There are several challenges to inner ear drug delivery and imaging due to the existence of tight biological barriers to the target structure and the dense bone surrounding it. Advances in imaging and nanomedicine may provide knowledge for overcoming the existing limitations to both the diagnosis and treatment of inner ear diseases. Novel techniques have improved the efficacy of drug delivery and targeting to the inner ear, as well as the quality and accuracy of imaging this structure. In this review, we will describe the pathways and biological barriers of the inner ear regarding drug delivery, the beneficial applications and limitations of the imaging techniques available for inner ear research, the behavior of engineered nanomaterials in inner ear applications, and future perspectives for nanomedicine-based inner ear imaging.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology – Head and Neck Surgery, Center for Otolaryngology – Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Otolaryngology, School of Medicine, University of Tampere, Tampere, Finland
| | - Jari Hyttinen
- Department of Electronics and Communications Engineering, BioMediTech, Tampere University of Technology, Tampere, Finland
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Mittmann P, Todt I, Ernst A, Rademacher G, Mutze S, Göricke S, Schlamann M, Lang S, Arweiler-Harbeck D, Christov F. Radiological and NRT-Ratio-Based Estimation of Slim Straight Cochlear Implant Electrode Positions: A Multicenter Study. Ann Otol Rhinol Laryngol 2016; 126:73-78. [PMID: 27780910 DOI: 10.1177/0003489416675355] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES An intraoperative neural response telemetry-ratio (NRT-ratio) was established, which can provide information about the intraoperative intracochlear electrode array position for perimodiolar electrodes. METHODS In a retrospective controlled study in 2 tertiary referral centers, the electrophysiological data sets of 50 patients with measured intraoperative auto-NRTs and postoperative radiological examinations were evaluated. All patients were implanted with Nucleus slim straight electrodes. The NRT-ratio was calculated by dividing the average auto-NRT data from electrodes 16 to 18 with the average from electrodes 5 to 7. Using a flat panel tomography system or a computed tomography, the position of the electrode array was certified radiological. RESULTS Radiologically, 2 out of 50 patients were identified with an electrode translocated from the scala tympani into the scala vestibuli. The radiologically estimated electrodes indicating a scalar change showed a regular NRT-ratio but nonspecific NRT-level changes at the localization of translocation.
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Affiliation(s)
| | - Ingo Todt
- Department of Otolaryngology, ukb Berlin, Germany
| | | | | | | | - Sophia Göricke
- Department of Neuroradiology and Radiology, University Hospital of Essen, University Duisburg-Essen, Essen, Nordrhein-Westfalen, Germany
| | - Marc Schlamann
- Department of Neuroradiology and Radiology, University Hospital Giessen and Marburg GmbH, Germany
| | - Stephan Lang
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Essen, University Duisburg-Essen, Germany
| | - Diana Arweiler-Harbeck
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Essen, University Duisburg-Essen, Germany
| | - Florian Christov
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Essen, University Duisburg-Essen, Germany
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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.
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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
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