Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA.
Otol Neurotol. 2019 Sep;40(8):1006-1010. doi: 10.1097/MAO.0000000000002296.
OBJECTIVE: The objective of this study is to determine the reliability of a new tablet-based software that utilizes postoperative computed tomography to determine angular insertion depth (AID), cochlear duct length (CDL), and the cochlear place frequency of individual electrodes in cochlear implant recipients. PATIENTS: Twenty adult cochlear implant recipients with lateral-wall electrode arrays of varying lengths were included in the study. INTERVENTION: Cochlear and electrode array measurements were made by 2 otolaryngologists using a tablet-based software. The user manually identifies the modiolus, round window, and each electrode contact to calculate AID. The user also manually identifies cochlear landmarks to calculate the CDL. The AID and CDL are applied to the Greenwood function to obtain an estimate of the cochlear place frequency for each electrode. MAIN OUTCOME MEASURE(S): The primary outcome measure was the reliability of the instrument, as assessed with intra and interrater reliability of measured AID and CDL. The resultant differences in the estimated cochlear place frequency of the most apical electrode were also evaluated. RESULTS: A broad range of AIDs were observed (390°-659°). Intraclass correlation coefficients for intra (0.991) and interrater reliability (0.980) of AID of the most apical electrode contact were excellent. Intra (0.820) and interrater reliability (0.784) of CDL were also excellent. The estimated cochlear place frequency for the most apical electrode differed by an average of 6.7% (0-18.7%) across the 2 raters. CONCLUSION: There is excellent agreement amongst clinicians in the determination of AID and CDL, resulting in small changes in estimated cochlear place frequency of the most apical electrode using this new software.
目的:本研究旨在确定一种新的基于平板电脑的软件的可靠性,该软件利用术后计算机断层扫描来确定角度插入深度(AID)、耳蜗管长度(CDL)以及耳蜗植入接受者个体电极的耳蜗位置频率。
患者:本研究纳入了 20 名接受侧墙电极阵列的成年耳蜗植入接受者,其电极阵列长度不一。
干预措施:两名耳鼻喉科医生使用基于平板电脑的软件进行耳蜗和电极阵列测量。用户手动识别蜗轴、圆窗和每个电极接触,以计算 AID。用户还手动识别耳蜗地标以计算 CDL。将 AID 和 CDL 应用于 Greenwood 函数,以获得每个电极的耳蜗位置频率的估计值。
主要观察指标:主要观察指标是仪器的可靠性,通过测量 AID 和 CDL 的内部和内部评分者可靠性来评估。还评估了最顶端电极的估计耳蜗位置频率的差异。
结果:观察到广泛的 AID(390°-659°)。最顶端电极接触的 AID 的内部(0.991)和内部评分者可靠性(0.980)的组内相关系数均为优秀。CDL 的内部(0.820)和内部评分者可靠性(0.784)也很好。使用新软件,最顶端电极的估计耳蜗位置频率平均相差 6.7%(0-18.7%)。
结论:在确定 AID 和 CDL 方面,临床医生之间存在极好的一致性,从而导致最顶端电极的估计耳蜗位置频率发生较小变化。
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