Lathuillière Marine, Merklen Fanny, Piron Jean-Pierre, Sicard Marielle, Villemus Françoise, Menjot de Champfleur Nicolas, Venail Frédéric, Uziel Alain, Mondain Michel
Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France.
Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France.
Int J Pediatr Otorhinolaryngol. 2017 Jan;92:27-31. doi: 10.1016/j.ijporl.2016.10.033. Epub 2016 Oct 31.
To assess the feasibility of using cone-beam computed tomography (CBCT) in young children with cochlear implants (CIs) and study the effect of intracochlear position on electrophysiological and behavioral measurements.
A total of 40 children with either unilateral or bilateral cochlear implants were prospectively included in the study. Electrode placement and insertion angles were studied in 55 Cochlear implants (16 straight arrays and 39 perimodiolar arrays), using either CBCT or X-ray imaging. CBCT or X-ray imaging were scheduled when the children were leaving the recovery room. We recorded intraoperative and postoperative neural response telemetry threshold (T-NRT) values, intraoperative and postoperative electrode impedance values, as well as behavioral T (threshold) and C (comfort) levels on electrodes 1, 5, 10, 15 and 20.
CBCT imaging was feasible without any sedation in 24 children (60%). Accidental scala vestibuli insertion was observed in 3 out of 24 implants as assessed by CBCT. The mean insertion angle was 339.7°±35.8°. The use of a perimodiolar array led to higher angles of insertion, lower postoperative T-NRT, as well as decreased behavioral T and C levels. We found no significant effect of either electrode array position or angle of insertion on electrophysiological data.
CBCT appears to be a reliable tool for anatomical assessment of young children with CIs. Intracochlear position had no significant effect on the electrically evoked compound action potential (ECAP) threshold. Our CBCT protocol must be improved to increase the rate of successful investigations.
评估在接受人工耳蜗植入（CI）的幼儿中使用锥形束计算机断层扫描（CBCT）的可行性，并研究耳蜗内电极位置对电生理和行为测量的影响。
本研究前瞻性纳入了40名单侧或双侧人工耳蜗植入儿童。使用CBCT或X线成像，对55个人工耳蜗（16个直电极阵列和39个蜗周电极阵列）的电极放置和插入角度进行研究。在患儿离开恢复室时安排CBCT或X线成像检查。我们记录了术中及术后神经反应遥测阈值（T-NRT）值、术中及术后电极阻抗值，以及电极1、5、10、15和20上的行为学阈值（T）和舒适阈（C）水平。
24名儿童（60%）在未使用任何镇静剂的情况下可行CBCT成像。通过CBCT评估，24个植入物中有3个出现意外的前庭阶插入。平均插入角度为339.7°±35.8°。使用蜗周电极阵列导致更高的插入角度、更低的术后T-NRT，以及行为学T和C水平降低，但电极阵列位置或插入角度对电生理数据均无显著影响。
CBCT似乎是评估接受CI的幼儿解剖结构的可靠工具。耳蜗内位置对电诱发复合动作电位（ECAP）阈值无显著影响。我们的CBCT方案必须改进，以提高成功检查率。
