Weber Lena, Kwok Pingling, Picou Erin M, Wendl Christina, Bohr Christopher, Marcrum Steven C
Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 2201 West End Avenue, Nashville, TN 37235, USA.
HNO. 2022 Oct;70(10):769-777. doi: 10.1007/s00106-022-01208-3. Epub 2022 Aug 15.
Cochlear duct length (CDL) is subject to significant individual variation. In the context of cochlear implantation, adapting the electrode array length to the CDL is of potential interest, as it has been associated with improvements in both speech recognition and sound quality. Using a tablet-based software package, it is possible to measure CDL at the level of the organ of Corti (CDL) to select appropriate electrode array lengths based on individual cochlear anatomy.
To identify effects of imaging modality and rater background on CDL estimates.
Magnetic resonance imaging (MRI) and flat-panel volume CT (fpVCT) scans of 10 patients (20 cochleae) were analyzed using the OTOPLAN software package (MED-EL, Innsbruck, Austria). Raters were an otorhinolaryngology (ORL) specialist, an ORL resident, and an audiologist. To analyze effects of rater background and imaging modality on CDL measurements, linear mixed models were constructed.
Measurements showed mean CDL(fpVCT) = 36.69 ± 1.78 mm and CDL(MRI) = 36.81 ± 1.87 mm. Analyses indicated no significant effect of rater background (F(2, 105) = 0.84; p = 0.437) on CDL estimates. Imaging modality, on the other hand, significantly affected CDL (F (1, 105) = 20.70; p < 0.001), whereby estimates obtained using MRI were 0.89 mm larger than those obtained using fpVCT.
No effect of rater background on CDL estimates could be identified, suggesting that comparable measurements could be obtained by personnel other than specially trained neurootologists. While imaging modality (fpVCT vs. MRI) did impact CDL results, the difference was small and of questionable clinical significance.
蜗管长度(CDL)存在显著的个体差异。在人工耳蜗植入的背景下,使电极阵列长度与CDL相适配具有潜在的意义,因为这与语音识别和声音质量的改善相关。使用基于平板电脑的软件包,可以在柯蒂氏器水平测量CDL,以便根据个体耳蜗解剖结构选择合适的电极阵列长度。
确定成像方式和评估者背景对CDL估计值的影响。
使用OTOPLAN软件包(奥地利因斯布鲁克MED-EL公司)分析了10例患者(20个耳蜗)的磁共振成像(MRI)和平板容积CT(fpVCT)扫描图像。评估者包括一名耳鼻喉科(ORL)专家、一名ORL住院医师和一名听力学家。为了分析评估者背景和成像方式对CDL测量的影响,构建了线性混合模型。
测量结果显示,平均蜗管长度(fpVCT)=36.69±1.78mm,蜗管长度(MRI)=36.81±1.87mm。分析表明,评估者背景对CDL估计值没有显著影响(F(2, 105)=0.84;p=0.437)。另一方面,成像方式对CDL有显著影响(F(1, 105)=20.70;p<0.001),使用MRI获得的估计值比使用fpVCT获得的估计值大0.89mm。
未发现评估者背景对CDL估计值有影响,这表明未经专门训练的神经耳科医生以外的人员也能获得可比的测量结果。虽然成像方式(fpVCT与MRI)确实影响CDL结果,但差异很小,临床意义存疑。