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Imaging of the human cochlea using micro-computed tomography before and after cochlear implantation: comparison with cone-beam computed tomography

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Analysis of cochlear structures and postoperative temporal bone (TB) imaging are gaining importance in the evaluation of cochlear implantation (CI°). Our aims were to explore the microarchitecture of human cochlea using micro-computed tomography (μCT), analyze electrode’s placement inside cochlea after CI°, and compare pre-/post-implantation μCT scans with cone-beam CT (CBCT) scans of same TBs.

Methods

Cadaveric TBs were scanned using μCT and CBCT then underwent CI° using straight electrodes. Thereafter, they underwent again μCT and CBCT-imaging.

Results

Ten TBs were studied. μCT allowed visualization of scala tympani, scala vestibuli, basilar membrane, osseous spiral lamina, crista fenestrae, and spiral ligament. CBCT showed same structures except spiral ligament and crista fenestrae. After CI°, μCT and CBCT displayed the scalar location and course of electrode array within the cochlea. There were 7 cases of atraumatic electrode insertion and 3 cases of insertion trauma: basilar membrane elevation, electrode foldover with limited migration into scala vestibuli, and electrode kinking with limited migration into scala vestibuli. Insertion trauma was not correlated with cochlea’s size or crista’s maximal height but with round window membrane diameter. Resolution of μCT was higher than CBCT but electrode artifacts were similar.

Conclusions

μCT was accurate in visualizing cochlear structures, and course and scalar position of electrode array inside cochlea with any possible trauma to cochlea or array. CBCT offers a good alternative to μCT in clinical practice for cochlear imaging and evaluation of CI°, with lower radiation and higher resolution than multi-slice CT. Difficulties related to non-traumatic CI° are multifactorial.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank MED-EL Elektromedizinische Geraete GmbH, Innsbruck–Austria for freely providing the FLEX26 electrodes used in this study.

Funding

None.

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Authors and Affiliations

  1. Service Oto-Rhino-Laryngologie, Division of Otology/Neurotology, Hôpital Nord, University Medical Center of Saint-Etienne, CHU Saint-Etienne, 42055, Saint-Etienne, France

    Alexandre Karkas

  2. Laboratory of Biology of Osteo-Articular Tissues, SAINBIOSE Inserm U1059, Saint-Etienne, France

    Alexandre Karkas, Pierre Boureille, Norbert Laroche, Laurence Vico & Hubert Marotte

  3. Laboratory of Anatomy of Medical School Jacques Lisfranc, Saint-Etienne, France

    Alexandre Karkas & Florian Bergandi

  4. Division of Neuroradiology, University Medical Center of Saint-Etienne, Saint-Etienne, France

    Pierre Boureille

  5. Department of Rheumatology, University Medical Center of Saint-Etienne, Saint-Etienne, France

    Hubert Marotte

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  1. Alexandre Karkas
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  2. Pierre Boureille
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  3. Norbert Laroche
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  4. Laurence Vico
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Correspondence to Alexandre Karkas.

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Karkas, A., Boureille, P., Laroche, N. et al. Imaging of the human cochlea using micro-computed tomography before and after cochlear implantation: comparison with cone-beam computed tomography. Eur Arch Otorhinolaryngol 280, 3131–3140 (2023). https://doi.org/10.1007/s00405-022-07811-y

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