Harris Robert, Pepper Chris, Dennis Lee, Rich Phillip, Selvadurai David
Department of Otolaryngology, St George's Hospital, London, UK.
Cochlear Implants Int. 2011 Feb;12(1):53-6. doi: 10.1179/146701010X486408.
'Stenver's' is the standard plain radiograph view to check the electrode position after cochlear implantation. However, a reproducible alignment for intra-individual comparison of electrode position using a true Stenver's alignment is not always straightforward to achieve, particularly for inexperienced radiographers, or on non-compliant children. In addition, two ionizing exposures in two different positions are required for bilateral cochlear implants.
To assess the efficacy of other, more simple, single-exposure radiographs for the assessment of electrode position.
Dummy electrodes and receiver units were bilaterally implanted into a cadaver. Plain radiographs in Stenver's views, and plain antero-posterior (AP) midline radiographic single views incorporating both implants were obtained with the tube at a range of angles tilted caudal and cranial to the perpendicular. Five internationally renowned cochlear implant surgeons were each asked if each radiograph gave adequate information for unilateral and for bilateral implants and they were asked to list in order of their favoured top three views.
No surgeon thought that a single-exposure Stenver's view was adequate for assessment of the contra-lateral side. Consensus was that all AP views were fit for the purpose, with no preference given between each of the AP views. The ipsi-lateral Stenver's was considered to give better depth of insertion information.
There is no apparent advantage of caudal and cranial tilt angles over a straight perpendicular AP. A single-view AP radiograph is an alternative to Stenver's view for a post-unilateral and post-simultaneous bilateral cochlear implant check.
“斯滕弗位”是人工耳蜗植入术后检查电极位置的标准平片视图。然而，使用真正的斯滕弗位对齐方式进行个体内电极位置比较时，要实现可重复的对齐并非总是那么简单，尤其是对于经验不足的放射技师，或者不配合的儿童。此外，双侧人工耳蜗植入需要在两个不同位置进行两次电离辐射曝光。
评估其他更简单的单次曝光平片用于评估电极位置的有效性。
将模拟电极和接收器单元双侧植入一具尸体。在管球向尾侧和头侧倾斜至与垂线呈一定角度的情况下，分别获得斯滕弗位平片以及包含双侧植入物的前后位（AP）中线平片单视图。分别询问五位国际知名的人工耳蜗植入外科医生，每张平片对于单侧和双侧植入物是否能提供足够信息，并要求他们按偏好顺序列出前三的视图。
没有外科医生认为单次曝光的斯滕弗位视图足以评估对侧。大家的共识是所有AP视图都适用于此目的，且各AP视图之间没有偏好之分。同侧的斯滕弗位被认为能提供更好的植入深度信息。
与直接垂直的前后位相比，向尾侧和头侧倾斜角度并无明显优势。对于单侧和双侧人工耳蜗植入术后检查，单视图前后位平片可替代斯滕弗位视图。
