Advanced Bionics, European Research Center, Hannover, Germany.
Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland.
Sci Rep. 2023 Jul 31;13(1):12416. doi: 10.1038/s41598-023-39275-3.
As of today, image-based assessment of cochlear implant electrode array location is not part of the clinical routine. Low resolution and contrast of computer tomography (CT) imaging, as well as electrode array artefacts, prevent visibility of intracochlear structures and result in low accuracy in determining location of the electrode array. Further, trauma assessment based on clinical-CT images requires a uniform image-based trauma scaling. Goal of this study was to evaluate the accuracy of a novel imaging software to detect electrode scalar location. Six cadaveric temporal bones were implanted with Advanced Bionics SlimJ and Mid-Scala electrode arrays. Clinical-CT scans were taken pre- and postoperatively. In addition, micro-CTs were taken post-operatively for validation. The electrode scalar location rating done by the software was compared to the rating of two experienced otosurgeons and the micro-CT images. A 3-step electrode scalar location grading scale (0 = electrode in scala tympani, 1 = interaction of electrode with basilar membrane/osseous spiral lamina, 2 = translocation of electrode into scala vestibuli) was introduced for the assessment. The software showed a high sensitivity of 100% and a specificity of 98.7% for rating the electrode location. The correlation between rating methods was strong (kappa > 0.890). The software gives a fast and reliable method of evaluating electrode scalar location for cone beam CT scans. The introduced electrode location grading scale was adapted for assessing clinical CT images.
截至今日，基于影像的人工耳蜗电极位置评估尚未成为临床常规。计算机断层扫描（CT）成像的分辨率和对比度低，以及电极阵列伪影，使得耳蜗内结构的可视化程度降低，导致电极位置的确定准确性降低。此外，基于临床 CT 图像的创伤评估需要统一的基于影像的创伤评分。本研究的目的是评估一种新型成像软件在检测电极位置方面的准确性。将 6 具尸体颞骨植入 Advanced Bionics SlimJ 和 Mid-Scala 电极阵列。分别在术前和术后进行临床 CT 扫描。此外，还在术后进行了 micro-CT 扫描以验证。软件对电极位置的评级与两位经验丰富的耳科医生和 micro-CT 图像的评级进行了比较。引入了一个 3 级电极位置分级量表（0=电极在鼓阶，1=电极与基底膜/骨螺旋板相互作用，2=电极移位到前庭阶）用于评估。该软件在评估电极位置方面具有 100%的高灵敏度和 98.7%的特异性。各种评分方法之间的相关性很强（kappa>0.890）。该软件为评估锥形束 CT 扫描中的电极位置提供了一种快速可靠的方法。引入的电极位置分级量表适用于评估临床 CT 图像。
