1
|
Canzi P, Carlotto E, Zanoletti E, Frijns JHM, Borsetto D, Caruso A, Chiapparini L, Ciorba A, Conte G, Creber N, Criscuolo S, Di Lella F, Franchella S, Hensen EF, Lauda L, Malpede S, Mandalà M, Rotteveel LJC, Simoncelli A, Stellato AC, Zanetti D, Benazzo M. Multi-Magnet Cochlear Implant Technology and Magnetic Resonance Imaging: The Safety Issue. Audiol Res 2024; 14:401-411. [PMID: 38804458 DOI: 10.3390/audiolres14030034] [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: 03/19/2024] [Revised: 04/07/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European survey about this topic was conducted focusing on safety issues, and the results were compared with the current literature. We collected a total of 65 MRI scans performed in 9 otologic referral centers for a total of 47 Hires Ultra 3D recipients, including, for the first time, 2 children and 3 teenagers. Preventive measures were represented by scanning time and sedation for children. Head wrapping was used in eight cases, and six of the eight cases received local anesthesia, even if both measures were not needed. Only three patients complained of pain (3/65 examinations, 4.6%) due to the tight head bandage, and one of the three cases required MRI scan interruption. No other adverse events were reported. We believe that these results should encourage MRI execution in accordance with manufacturer recommendations for Ultra 3D recipients.
Collapse
Affiliation(s)
- Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Elena Carlotto
- Department of Otolaryngology, S. Croce Hospital, 12100 Cuneo, Italy
| | - Elisabetta Zanoletti
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35127 Padova, Italy
| | - Johan H M Frijns
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Antonio Caruso
- Department of Otology and Skull Base Surgery, Otologic Group, 29121 Piacenza, Italy
| | - Luisa Chiapparini
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Andrea Ciorba
- ENT and Audiology Department, University Hospital of Ferrara, 44122 Ferrara, Italy
| | - Giorgio Conte
- Neuroradiology Department Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy
| | - Nathan Creber
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Stefania Criscuolo
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Filippo Di Lella
- Otolaryngology and Otoneurosurgery Unit, University of Parma, 43126 Parma, Italy
| | - Sebastiano Franchella
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padova, 35127 Padova, Italy
| | - Erik F Hensen
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Lorenzo Lauda
- Department of Otology and Skull Base Surgery, Otologic Group, 29121 Piacenza, Italy
| | - Stefano Malpede
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Marco Mandalà
- Department of Otology and Skull Base Surgery, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | - Liselotte J C Rotteveel
- Department of Otorhinolaryngology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Anna Simoncelli
- Department of Diagnostic Radiology and Interventional Radiology and Neuroradiology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Anna Chiara Stellato
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Diego Zanetti
- Audiology Unit, Department of Specialistic Surgical Sciences Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico Milan, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| |
Collapse
|
2
|
Mosconi M, Carlotto E, Caliogna L, Berni M, Gastaldi G, Conti M, Brancato AM, Bina V, Minervini D, Malpede S, Stellato AC, Lazzerini F, Bruschini L, Benazzo M, Canzi P. Titanium Biohybrid Middle Ear Prostheses: A Preliminary In Vitro Study. J Funct Biomater 2023; 14:561. [PMID: 38132815 PMCID: PMC10743766 DOI: 10.3390/jfb14120561] [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: 10/30/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023] Open
Abstract
Ossiculoplasty is a surgical operation performed to restore auditory transmission through the reconstruction of the ossicular chain using prosthetics. Tissue bioengineering has assumed a pivotal role in implementing alternatives to conventional ossicular middle ear replacement prostheses, to overcome extrusion while preserving acoustic properties. This in vitro study aims to explore, for the first time in current literature, the feasibility of a biohybrid middle ear prosthesis, composed of titanium surrounded by a bone extracellular matrix as bio-coating. We have hereby studied the adhesion and proliferation of human adipose-derived mesenchymal stem cells (hASC) on titanium scaffolds in vitro. Moreover, we identified the osteogenic differentiation of hASC using an immunofluorescence assay to analyze osteoblasts' gene expression profiles (Alp, Runx2, Col1a1, Osx, and Bglap), and we counted the presence of collagen as a marker of hASC's ability to secrete an extracellular matrix. We utilized scanning electron microscopy to evaluate the presence of an extracellular matrix on the scaffolds. Our preliminary data demonstrated the titanium's ability to support human adipose-derived mesenchymal stem cell colonization, proliferation, and osteoblastic differentiation, in order to obtain a biohybrid device. Our experience seems encouraging; thus, we advocate for further in vivo research to corroborate our results regarding bone transplantation.
Collapse
Affiliation(s)
- Mario Mosconi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Elena Carlotto
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Laura Caliogna
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Micaela Berni
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Giulia Gastaldi
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Centre for Health Technologies, University of Pavia, 27100 Pavia, Italy
| | - Michele Conti
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Via Ferrata 3, 27100 Pavia, Italy
| | - Alice Maria Brancato
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Valentina Bina
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Domenico Minervini
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Stefano Malpede
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Anna Chiara Stellato
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Francesco Lazzerini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56124 Pisa, Italy
| | - Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56124 Pisa, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| |
Collapse
|
3
|
Canzi P, Carlotto E, Bruschini L, Minervini D, Mosconi M, Caliogna L, Ottoboni I, Chiapperini C, Lazzerini F, Forli F, Berrettini S, Benazzo M. Extrusion and Dislocation in Titanium Middle Ear Prostheses: A Literature Review. Brain Sci 2023; 13:1476. [PMID: 37891843 PMCID: PMC10605711 DOI: 10.3390/brainsci13101476] [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: 09/10/2023] [Revised: 10/15/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Titanium middle ear (ME) prostheses are widely used in surgical practice due to their acoustic properties. However, they present a significant drawback shared by all synthetic materials currently in use for ME reconstruction: they can be rejected by the organism of the host. In this study, we aim to review the current literature on titanium partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs) extrusion and dislocation. Eighty articles were analysed after a full article review based on the inclusion and exclusion criteria. The most common indication for reconstruction was chronic otitis media with cholesteatoma. The average extrusion or dislocation rate was 5.2%, ranging from 0 to 35%. The average improvements in the air-bone gap were 12.1 dB (1.6 dB to 25.1 dB) and 13.8 (-0.5 dB to 22.7 dB) for the PORP and TORP groups, respectively. The data reported on this topic are highly variable, demonstrating that functional outcomes are difficult to predict in clinical practice. We believe that the current limitations could be overcome with technological developments, including bioengineering research focused on promoting prosthesis adaptation to the ME environment.
Collapse
Affiliation(s)
- Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Elena Carlotto
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56126 Pisa, Italy
| | - Domenico Minervini
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Mario Mosconi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Laura Caliogna
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Ilaria Ottoboni
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Cesare Chiapperini
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Francesco Lazzerini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56126 Pisa, Italy
| | - Francesca Forli
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56126 Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, 56126 Pisa, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy
| |
Collapse
|