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Insertion characteristics and placement of the Mid-Scala electrode array in human temporal bones using detailed cone beam computed tomography

  • Otology
  • Published:
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Abstract

The aim of this study was to evaluate the insertion results and placement of the new Advanced Bionics HiFocus Mid-Scala (HFms) electrode array, inserted through the round window membrane, in eight fresh human temporal bones using cone beam computed tomography (CBCT). Pre- and post-insertion CBCT scans were registered to create a 3D reconstruction of the cochlea with the array inserted. With an image fusion technique both the bony edges of the cochlea and the electrode array in situ could accurately be determined, thus enabling to identify the exact position of the electrode array within the scala tympani. Vertical and horizontal scalar location was measured at four points along the cochlea base at an angular insertion depth of 90°, 180° and 270° and at electrode 16, the most basal electrode. Smooth insertion through the round window membrane was possible in all temporal bones. The imaging results showed that there were no dislocations from the scala tympani into the scala vestibule. The HFms electrode was positioned in the middle of the scala along the whole electrode array in three out of the eight bones and in 62 % of the individual locations measured along the base of the cochlea. In only one cochlea a close proximity of the electrode with the basilar membrane was observed, indicating possible contact with the basilar membrane. The results and assessments presented in this study appear to be highly accurate. Although a further validation including histopathology is needed, the image fusion technique described in this study represents currently the most accurate method for intracochlear electrode assessment obtainable with CBCT.

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Acknowledgments

The authors would like to thank Guido Dees, Marc van Hoof and Robert Stokroos from the Maastricht University Medical Centre (MUMC) in the Netherlands for the exchange of expertise on the image fusion and concepts of image processing used in this research.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland

    Aarno Dietz & Heikki Löppönen

  2. Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

    Aarno Dietz & Heikki Löppönen

  3. Clinical Research Department International, Advanced Bionics AG, Stäfa, Switzerland

    Dzemal Gazibegovic

  4. Department of Clinical Radiology, Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland

    Jyrki Tervaniemi & Veli-Matti Vartiainen

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  1. Aarno Dietz
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  2. Dzemal Gazibegovic
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  3. Jyrki Tervaniemi
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  4. Veli-Matti Vartiainen
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  5. Heikki Löppönen
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Correspondence to Aarno Dietz.

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Conflict of interest

Author Dzemal Gazibegovic is an employee of Advanced Bionics’ AG clinical research department. The other authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in this study involving human material were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Dietz, A., Gazibegovic, D., Tervaniemi, J. et al. Insertion characteristics and placement of the Mid-Scala electrode array in human temporal bones using detailed cone beam computed tomography. Eur Arch Otorhinolaryngol 273, 4135–4143 (2016). https://doi.org/10.1007/s00405-016-4099-x

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  • DOI: https://doi.org/10.1007/s00405-016-4099-x

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