Markodimitraki Laura M, Stegeman Inge, Smit Adriana L, Thomeer Hans G X M
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.
University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.
Front Surg. 2020 Jan 15;6:78. doi: 10.3389/fsurg.2019.00078. eCollection 2019.
Postoperative follow-up after cochlear implantation lacks a reliable screening method to detect cochlear implant receiver device migration. This study aims to validate a clinically applicable method to assess the position and migration of the cochlear implant receiver device. Validation study. Tertiary university medical center. To assess the cochlear implant receiver device location, round markers representing the external magnet were placed on both sides of the head of volunteers. Four independent clinicians took measurements of the distances between reference points on the head and the center of the marker. The reference points were: the lateral canthus (LC), tragus tip (TT), the mastoid angle (MA), and the mandibular angle (AM). The inter-clinician reliability was determined by calculating the intraclass correlation coefficient (ICC) and confidence interval (CI) with a two-way mixed model and both consistency and absolute agreement types for each distance. Eight volunteers were included resulting in 16 individual cases. The consistency type ICC's for each reference point were: LC 0.90 (CI = 0.80, 0.96), TT 0.83 (CI = 0.69, 0.93), MA 0.75 (CI = 0.56, 0.89), and AM 0.29 (CI = 0.05, 0.59). The absolute agreement ICC's were: LC 0.87 (CI = 0.73, 0.95), TT 0.83 (CI = 0.68, 0.93), MA 0.68 (CI = 0.42, 0.86), and AM 0.18 (CI = 0.01, 0.46). The inter-clinician reliability was good to excellent for the lateral canthus and tragus tip reference points. The cochlear receiver device location can be assessed reliably by measuring the distance between the LC, TT, and the external magnet. This method can be used to registrate implant receiver location after implantation and detect implant migration postoperatively.
人工耳蜗植入术后的随访缺乏可靠的筛查方法来检测人工耳蜗接收器装置的移位。本研究旨在验证一种临床适用的方法,以评估人工耳蜗接收器装置的位置和移位情况。验证性研究。三级大学医学中心。为了评估人工耳蜗接收器装置的位置,在志愿者头部两侧放置代表外部磁铁的圆形标记。四名独立的临床医生测量了头部参考点与标记中心之间的距离。参考点包括:外眦(LC)、耳屏尖(TT)、乳突角(MA)和下颌角(AM)。通过计算组内相关系数(ICC)和置信区间(CI),采用双向混合模型以及每种距离的一致性和绝对一致性类型来确定临床医生之间的可靠性。纳入了八名志愿者,产生了16个个体病例。每个参考点的一致性类型ICC分别为:LC 0.90(CI = 0.80, 0.96),TT 0.83(CI = 0.69, 0.93),MA 0.75(CI = 0.56, 0.89),AM 0.29(CI = 0.05, 0.59)。绝对一致性ICC分别为:LC 0.87(CI = 0.73, 0.95),TT 0.83(CI = 0.68, 0.93),MA 0.68(CI = 0.42, 0.86),AM 0.18(CI = 0.01, 0.46)。对于外眦和耳屏尖参考点,临床医生之间的可靠性良好至优秀。通过测量LC、TT与外部磁铁之间的距离,可以可靠地评估人工耳蜗接收器装置的位置。该方法可用于在植入后记录植入接收器的位置,并在术后检测植入物的移位情况。