同一制造商的耳蜗再植入术后的电极阵列定位。
Electrode array positioning after cochlear reimplantation from single manufacturer.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN 37232, USA.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN 37232, USA.
出版信息
Cochlear Implants Int. 2023 Sep;24(5):273-281. doi: 10.1080/14670100.2023.2179756. Epub 2023 Feb 22.
OBJECTIVE
To investigate whether revision surgery with the same device results in a change in three key indicators of electrode positioning: scalar location, mean modiolar distance (), and angular insertion depth (AID).
METHODS
Retrospective analysis of a cochlear implant database at a university-based tertiary medical center. Intra-operative CT scans were obtained after initial and revision implantation. Electrode array (EA) position was calculated using auto-segmentation techniques. Initial and revision scalar location, , and AID were compared.
RESULTS
Mean change in for all ears was -0.07 mm (SD 0.24 mm; = 0.16). The mean change in AID for all ears was -5° (SD 67°; = 0.72). Three initial implantations with pre-curved EAs resulted in a translocation from Scala Tympani (ST) to Scala Vestibuli (SV). Two remained translocated after revision, while one was corrected when revised with a straight EA. An additional five translocations occurred after revision.
CONCLUSIONS
In this study examining revision cochlear implantation from a single manufacturer, we demonstrated no significant change in key indicators of EA positioning, even when revising with a different style of electrode. However, the revision EA is not necessarily confined by the initial trajectory and there may be an increased risk of translocation.
目的
研究使用相同器械进行翻修手术是否会改变电极定位的三个关键指标：标度位置、中轴耳蜗距（）和角插入深度（AID）。
方法
对大学附属医院的一个人工耳蜗植入数据库进行回顾性分析。在初次和翻修植入后获取术中 CT 扫描。使用自动分割技术计算电极阵列（EA）的位置。比较初始和翻修后的标度位置、和 AID。
结果
所有耳朵的平均变化为-0.07 mm（SD 0.24 mm；=0.16）。所有耳朵的 AID 平均变化为-5°（SD 67°；=0.72）。三个初始植入的预弯 EA 导致从鼓阶（ST）到前庭阶（SV）的移位。两次翻修后仍有移位，而一次使用直 EA 翻修时得到纠正。另外五个在翻修后发生了移位。
结论
在这项研究中，我们从单一制造商的角度检查了人工耳蜗翻修植入，即使使用不同样式的电极，也没有显示出 EA 定位关键指标的显著变化。然而，翻修 EA 不一定局限于初始轨迹，可能会增加移位的风险。
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