Department of Otology-Neurotology and Skull Base Surgery, Purpan University Hospital, Place du Docteur Baylac, 31059, Toulouse, France,
Eur Arch Otorhinolaryngol. 2014 Apr;271(4):673-9. doi: 10.1007/s00405-013-2448-6. Epub 2013 Mar 28.
Postoperative imaging plays a growing role in clinical studies concerning prognostic factors in cochlear implantation. Indeed, intracochlear position of the cochlear implant has recently been identified as a contributor in functional outcomes and radiological tools must be accurate enough to determine the final placement of the electrode array. The aim of our study was to validate cone beam computed tomography as a reliable technique for scalar localization of the electrode array. We performed therefore a temporal bone study on ten specimens that were implanted with a perimodiolar implant prototype. Cone beam reconstructions were performed and images were analyzed by two physicians both experienced in cochlear implant imaging, who determined the scalar localization of the implant. Temporal bones then underwent histological control to document this scalar localization and hypothetical intracochlear lesions. In four cases, a dislocation from scala tympani to scala vestibuli was suspected on cone beam reconstructions of the ascending part of the basal turn. In three of these four specimens, dislocation in pars ascendens was confirmed histologically. In the remaining temporal bone, histological analysis revealed an elevation with rupture of the basilar membrane. Histological assessment revealed spiral ligament tearing in another bone. We conclude that cone beam is a reliable tool to assess scalar localization of the selectrode array and may be used in future clinical studies.
术后影像学在涉及耳蜗植入预后因素的临床研究中发挥着越来越重要的作用。事实上，耳蜗植入物的耳蜗内位置最近被确定为功能结果的一个贡献因素，因此放射学工具必须足够精确，以确定电极阵列的最终位置。我们的研究目的是验证锥形束 CT 作为一种可靠的方法，用于对电极阵列进行标量定位。为此，我们对十具植入了一种peri-modolar 植入物原型的颞骨标本进行了研究。进行了锥形束重建，并由两位在耳蜗植入成像方面都有经验的医生对图像进行了分析，他们确定了植入物的标量定位。然后，颞骨进行了组织学对照，以记录这种标量定位和假设的耳蜗内病变。在四个病例中，在基底回升部的锥形束重建中怀疑从鼓阶到前庭阶的脱位。在这四个标本中的三个中，升支的脱位在组织学上得到了证实。在剩余的颞骨中，组织学分析显示基底膜破裂引起的隆起。在另一块骨中，组织学评估显示螺旋韧带撕裂。我们得出结论，锥形束是评估选择电极阵列标量定位的可靠工具，并可用于未来的临床研究。
