Schraivogel Stephan, Regele Sabrina, Weiss Nora M, Wirth Markus, Wollenberg Barbara, Caversaccio Marco, Wimmer Wilhelm
Department of ENT, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.
ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Eur Arch Otorhinolaryngol. 2025 Aug;282(8):4349-4352. doi: 10.1007/s00405-025-09397-7. Epub 2025 Apr 29.
Detection of complications during rehabilitation and postoperative follow-up after cochlear implantation is essential, especially in children and cognitively impaired patients. Electrode array migration can affect outcomes and must be detected early. Traditional radiographic methods, although effective, are costly and expose patients to radiation. This case report discusses the use of a previously published impedance-based model for cochlear implant array localization in a child with Aymé-Gripp syndrome.
Impedance telemetry data and X-ray images were collected at the time of initial surgery and before and after the required revision surgery. The impedance-based model was used to estimate the insertion depth of the most basal cochlear implant electrode within the cochlea. The resulting estimates were compared with the electrode positions from radiographs to assess the accuracy and applicability of the model.
20 months after implantation, the patient suddenly stopped tolerating the CI audio processor. Retrospectively, the impedance-based model revealed substantial electrode migration, which was confirmed by postoperative radiography.
The proposed model, which uses routine impedance telemetry data without radiation exposure, offers a cost-effective alternative to radiography. Early detection and intervention, particularly in complex cases, improves outcomes and reduces costs, highlighting the importance of objective monitoring.
在人工耳蜗植入后的康复及术后随访过程中检测并发症至关重要,尤其是对于儿童和认知障碍患者。电极阵列移位会影响手术效果,必须尽早发现。传统的放射学方法虽然有效,但成本高昂且会使患者暴露于辐射之下。本病例报告讨论了一种先前发表的基于阻抗的模型在一名患有艾梅-格里普综合征儿童人工耳蜗植入阵列定位中的应用。
在初次手术时以及所需的翻修手术前后收集阻抗遥测数据和X线图像。使用基于阻抗的模型来估计人工耳蜗最底部电极在耳蜗内的插入深度。将所得估计值与X线片上的电极位置进行比较,以评估该模型的准确性和适用性。
植入后20个月,患者突然无法耐受人工耳蜗音频处理器。回顾性分析显示,基于阻抗的模型表明电极发生了明显移位,术后X线检查证实了这一点。
所提出的模型利用常规阻抗遥测数据,无需暴露于辐射之下,为放射学检查提供了一种经济有效的替代方法。早期检测和干预,尤其是在复杂病例中,可改善手术效果并降低成本,凸显了客观监测的重要性。