Top

Published in:

Open Access 01-02-2022 | Digital Volume Tomography | Experimental

CT imaging-based approaches to cochlear duct length estimation—a human temporal bone study

Authors: Tabita Breitsprecher, Anandhan Dhanasingh, Marko Schulze, Markus Kipp, Rami Abu Dakah, Tobias Oberhoffner, Michael Dau, Bernhard Frerich, Marc-André Weber, Soenke Langner, Robert Mlynski, Nora M. Weiss

Published in: European Radiology | Issue 2/2022

Abstract

Objectives

Knowledge about cochlear duct length (CDL) may assist electrode choice in cochlear implantation (CI). However, no gold standard for clinical applicable estimation of CDL exists. The aim of this study is (1) to determine the most reliable radiological imaging method and imaging processing software for measuring CDL from clinical routine imaging and (2) to accurately predict the insertion depth of the CI electrode.

Methods

Twenty human temporal bones were examined using different sectional imaging techniques (high-resolution computed tomography [HRCT] and cone beam computed tomography [CBCT]). CDL was measured using three methods: length estimation using (1) a dedicated preclinical 3D reconstruction software, (2) the established A-value method, and (3) a clinically approved otosurgical planning software. Temporal bones were implanted with a 31.5-mm CI electrode and measurements were compared to a reference based on the CI electrode insertion angle measured by radiographs in Stenvers projection (CDL_reference).

Results

A mean cochlear coverage of 74% (SD 7.4%) was found. The CDL_reference showed significant differences to each other method (p < 0.001). The strongest correlation to the CDL_reference was found for the otosurgical planning software-based method obtained from HRCT (CDL_SW-HRCT; r = 0.87, p < 0.001) and from CBCT (CDL_SW-CBCT; r = 0.76, p < 0.001). Overall, CDL was underestimated by each applied method. The inter-rater reliability was fair for the CDL estimation based on 3D reconstruction from CBCT (CDL_3D-CBCT; intra-class correlation coefficient [ICC] = 0.43), good for CDL estimation based on 3D reconstruction from HRCT (CDL_3D-HRCT; ICC = 0.71), poor for CDL estimation based on the A-value method from HRCT (CDL_A-HRCT; ICC = 0.29), and excellent for CDL estimation based on the A-value method from CBCT (CDL_A-CBCT; ICC = 0.87) as well as for the CDL_SW-HRCT (ICC = 0.94), CDL_SW-CBCT (ICC = 0.94) and CDL_reference (ICC = 0.87).

Conclusions

All approaches would have led to an electrode choice of rather too short electrodes. Concerning treatment decisions based on CDL measurements, the otosurgical planning software-based method has to be recommended. The best inter-rater reliability was found for CDL_A-CBCT, for CDL_SW-HRCT, for CDL_SW-CBCT, and for CDL_reference.

Key Points

• Clinically applicable calculations using high-resolution CT and cone beam CT underestimate the cochlear size.

• Ten percent of cochlear duct length need to be added to current calculations in order to predict the postoperative CI electrode position.

• The clinically approved otosurgical planning software-based method software is the most suitable to estimate the cochlear duct length and shows an excellent inter-rater reliability.

Vermeire K, Nobbe A, Schleich P, Nopp P, Voormolen MH, Van de Heyning PH (2008) Neural tonotopy in cochlear implants: an evaluation in unilateral cochlear implant patients with unilateral deafness and tinnitus. Hear Res 245(1-2):98–106. https://doi.org/10.1016/j.heares.2008.09.003CrossRefPubMed

Buchner A, Illg A, Majdani O, Lenarz T (2017) Investigation of the effect of cochlear implant electrode length on speech comprehension in quiet and noise compared with the results with users of electro-acoustic-stimulation, a retrospective analysis. PLoS One 12(5):e0174900. https://doi.org/10.1371/journal.pone.0174900CrossRefPubMedPubMedCentral

Stakhovskaya O, Sridhar D, Bonham BH, Leake PA (2007) Frequency map for the human cochlear spiral ganglion: implications for cochlear implants. J Assoc Res Otolaryngol 8(2):220–233. https://doi.org/10.1007/s10162-007-0076-9CrossRefPubMedPubMedCentral

Timm ME, Majdani O, Weller T et al (2018) Patient specific selection of lateral wall cochlear implant electrodes based on anatomical indication ranges. PLoS One 13(10):e0206435. https://doi.org/10.1371/journal.pone.0206435CrossRefPubMedPubMedCentral

Xu J, Xu SA, Cohen LT, Clark GM (2000) Cochlear view: postoperative radiography for cochlear implantation. Am J Otol 21(1):49–56CrossRef

Dimopoulos P, Muren C (1990) Anatomic variations of the cochlea and relations to other temporal bone structures. Acta Radiol 31(5):439–444CrossRef

Rask-Andersen H, Erixon E, Kinnefors A, Lowenheim H, Schrott-Fischer A, Liu W (2011) Anatomy of the human cochlea--implications for cochlear implantation. Cochlear Implants Int 12(Suppl 1):S8–S13. https://doi.org/10.1179/146701011X13001035752174CrossRefPubMed

Avci E, Nauwelaers T, Lenarz T, Hamacher V, Kral A (2014) Variations in microanatomy of the human cochlea. J Comp Neurol 522(14):3245–3261. https://doi.org/10.1002/cne.23594CrossRefPubMedPubMedCentral

Wysocki J (1999) Dimensions of the human vestibular and tympanic scalae. Hear Res 135(1-2):39–46. https://doi.org/10.1016/s0378-5955(99)00088-xCrossRefPubMed

10.

Biedron S, Prescher A, Ilgner J, Westhofen M (2010) The internal dimensions of the cochlear scalae with special reference to cochlear electrode insertion trauma. Otol Neurotol 31(5):731–737. https://doi.org/10.1097/MAO.0b013e3181d27b5eCrossRefPubMed

11.

Escude B, James C, Deguine O, Cochard N, Eter E, Fraysse B (2006) The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurootol 11(Suppl 1):27–33. https://doi.org/10.1159/000095611CrossRefPubMed

12.

Shin K-J, Lee J-Y, Kim J-N et al (2013) Quantitative analysis of the cochlea using three-dimensional reconstruction based on microcomputed tomographic images. Anat Rec (Hoboken) 296(7):1083–1088. https://doi.org/10.1002/ar.22714

13.

Verbist BM, Ferrarini L, Briaire JJ et al (2009) Anatomic considerations of cochlear morphology and its implications for insertion trauma in cochlear implant surgery. Otol Neurotol 30(4):471–477. https://doi.org/10.1097/MAO.0b013e3181a32c0dCrossRefPubMed

14.

Weiss NM, Langner S, Mlynski R, Roland P, Dhanasingh A (2021) Evaluating common cavity cochlear deformities using CT images and 3D reconstruction. Laryngoscope 131(2):386–7391. https://doi.org/10.1002/lary.28640

15.

Weller T, Timm M, Büchner A, Lenarz T (2019) Individualisierte CI-Versorgung: Welchen Einfluss hat die Wahl des Elektrodenträgers?, 21. Jahrestagung der Deutschen Gesellschaft für Audiologie, Heidelberg, Germany (scientific report)

16.

Doubi A, Almuhawas F, Alzhrani F, Doubi M, Aljutaili H, Hagr A (2019) The effect of cochlear coverage on auditory and speech performance in cochlear implant patients. Otol Neurotol 40(5):602–607. https://doi.org/10.1097/MAO.0000000000002192CrossRefPubMed

17.

Mlynski R, Lüsebrink A, Oberhoffner T, Langner S, Weiss NM (2021) Mapping cochlear duct length to electrically evoked compound action potentials in cochlear implantation. Otol Neurotol 42(3):e254–7e260. https://doi.org/10.1097/MAO.0000000000002957

18.

Skinner MW, Ketten DR, Holden LK et al (2002) CT-derived estimation of cochlear morphology and electrode array position in relation to word recognition in Nucleus-22 recipients. J Assoc Res Otolaryngol 3(3):332–350. https://doi.org/10.1007/s101620020013CrossRefPubMedPubMedCentral

19.

Weiss NM, Dhanasingh A, Schraven SP, Schulze M, Langner S, Mlynski R (2019) Surgical approach for complete cochlear coverage in EAS-patients after residual hearing loss. PLoS One 14(9):e0223121. https://doi.org/10.1371/journal.pone.0223121CrossRefPubMedPubMedCentral

20.

Gaskell P, Muzaffar J, Colley S, Coulson C (2018) Can preoperative high resolution computed tomography be rationalized in adult cochlear implant candidates? Otol Neurotol 39(10):1264–1270. https://doi.org/10.1097/MAO.0000000000002027CrossRefPubMed

21.

Dhanasingh A, Jolly C (2017) An overview of cochlear implant electrode array designs. Hear Res 356:93–103. https://doi.org/10.1016/j.heares.2017.10.005CrossRefPubMed

22.

Nateghifard K, Low D, Awofala L et al (2019) Cone beam CT for perioperative imaging in hearing preservation Cochlear implantation - a human cadaveric study. J Otolaryngol Head Neck Surg 48(1):65. https://doi.org/10.1186/s40463-019-0388-xCrossRefPubMedPubMedCentral

23.

Schurzig D, Timm ME, Lexow GJ, Majdani O, Lenarz T, Rau TS (2018) Cochlear helix and duct length identification - evaluation of different curve fitting techniques. Cochlear Implants Int 19(5):268–283. https://doi.org/10.1080/14670100.2018.1460025CrossRefPubMed

24.

Würfel W, Lanfermann H, Lenarz T, Majdani O (2014) Cochlear length determination using cone beam computed tomography in a clinical setting. Hear Res 316:65–72. https://doi.org/10.1016/j.heares.2014.07.013CrossRefPubMed

25.

Kuthubutheen J, Grewal A, Symons S et al (2019) The effect of cochlear size on cochlear implantation outcomes. Biomed Res Int 2019:5849871. https://doi.org/10.1155/2019/5849871CrossRefPubMedPubMedCentral

26.

Li H, Schart-Morén N, Rohani SA, Ladak HM, Rask-Andersen H, Agrawal S (2020) Synchrotron radiation-based reconstruction of the human spiral ganglion: implications for cochlear implantation. Ear Hear 41(1):173–181. https://doi.org/10.1097/AUD.0000000000000738CrossRefPubMed

27.

Dhanasingh A (2019) Cochlear duct length along the outer wall vs organ of Corti: which one is relevant for the electrode array length selection and frequency mapping using Greenwood function? World J Otorhinolaryngol Head Neck Surg 5(2):117–121. https://doi.org/10.1016/j.wjorl.2018.09.004CrossRefPubMed

28.

Sieber D, Erfurt P, John S et al (2019) The OpenEar library of 3D models of the human temporal bone based on computed tomography and micro-slicing. Sci Data 6:180297. https://doi.org/10.1038/sdata.2018.297CrossRefPubMedPubMedCentral

29.

Cicchetti D (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instrument in psychology. Psychol Assess 6:284–290. https://doi.org/10.1037/1040-3590.6.4.284CrossRef

30.

Erixon E, Hogstorp H, Wadin K, Rask-Andersen H (2009) Variational anatomy of the human cochlea: implications for cochlear implantation. Otol Neurotol 30(1):14–22. https://doi.org/10.1097/MAO.0b013e31818a08e8CrossRefPubMed

31.

Koch RW, Elfarnawany M, Zhu N, Ladak HM, Agrawal SK (2017) Evaluation of cochlear duct length computations using synchrotron radiation phase-contrast imaging. Otol Neurotol 38(6):e92–e99. https://doi.org/10.1097/MAO.0000000000001410CrossRefPubMed

32.

Guenette JP (2021) Measuring the cochlea and cochlear implant electrode depth. Eur Radiol 31(3):1257–1259. https://doi.org/10.1007/s00330-020-07602-1CrossRefPubMed

33.

Canfarotta MW, Dillon MT, Buss E, Pillsbury HC, Brown KD, O’Connell BP (2019) Validating a new tablet-based tool in the determination of cochlear implant angular insertion depth. Otol Neurotol 40(8):1006–1010. https://doi.org/10.1097/MAO.0000000000002296CrossRefPubMedPubMedCentral

34.

Kawano A, Seldon HL, Clark GM (1996) Computer-aided three-dimensional reconstruction in human cochlear maps: measurement of the lengths of organ of Corti, outer wall, inner wall, and Rosenthal’s canal. Ann Otol Rhinol Laryngol 105(9):701–709. https://doi.org/10.1177/000348949610500906CrossRefPubMed

35.

Koch RW, Ladak HM, Elfarnawany M, Agrawal SK (2017) Measuring cochlear duct length - a historical analysis of methods and results. J Otolaryngol Head Neck Surg 46(1):19. https://doi.org/10.1186/s40463-017-0194-2CrossRefPubMedPubMedCentral

36.

Gee AH, Zhao Y, Treece GM, Bance ML (2021) Practicable assessment of cochlear size and shape from clinical CT images. Sci Rep 11(1):3448. https://doi.org/10.1038/s41598-021-83059-6CrossRefPubMedPubMedCentral

37.

Schurzig D, Timm ME, Batsoulis C et al (2018) A novel method for clinical cochlear duct length estimation toward patient-specific cochlear implant selection. OTO Open 2(4):2473974X18800238. https://doi.org/10.1177/2473974X18800238CrossRefPubMedPubMedCentral

38.

Khurayzi T, Almuhawas F, Sanosi A (2020) Direct measurement of cochlear parameters for automatic calculation of the cochlear duct length. Ann Saudi Med 40(3):212–218. https://doi.org/10.5144/0256-4947.2020.218CrossRefPubMedPubMedCentral

39.

Oh J, Cheon J-E, Park J et al (2021) Cochlear duct length and cochlear distance on preoperative CT: imaging markers for estimating insertion depth angle of cochlear implant electrode. Eur Radiol 31(3):1260–1267. https://doi.org/10.1007/s00330-020-07580-4CrossRefPubMed

40.

Knörgen M, Brandt S, Kösling S (2012) Comparison of quality on digital X-ray devices with 3D-capability for ENT-clinical objectives in imaging of temporal bone and paranasal sinuses. Rofo. 184(12):1153–1160. https://doi.org/10.1055/s-0032-1325343CrossRefPubMed

41.

Schurzig D, Lexow GJ, Majdani O, Lenarz T, Rau TS (2016) Three-dimensional modeling of the cochlea by use of an arc fitting approach. Comput Methods Biomech Biomed Engin 19(16):1785–1799. https://doi.org/10.1080/10255842.2016.1188921CrossRefPubMed

Title: CT imaging-based approaches to cochlear duct length estimation—a human temporal bone study
Authors: Tabita Breitsprecher
Anandhan Dhanasingh
Marko Schulze
Markus Kipp
Rami Abu Dakah
Tobias Oberhoffner
Michael Dau
Bernhard Frerich
Marc-André Weber
Soenke Langner
Robert Mlynski
Nora M. Weiss
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Digital Volume Tomography
Digital Volume Tomography
Cochlear Implant
Published in: European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08189-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

CT imaging-based approaches to cochlear duct length estimation—a human temporal bone study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 2/2022

Structured and shared CT radiological report of gastric cancer: a consensus proposal by the Italian Research Group for Gastric Cancer (GIRCG) and the Italian Society of Medical and Interventional Radiology (SIRM)

MRI-based radiomics nomogram for predicting temporal lobe injury after radiotherapy in nasopharyngeal carcinoma

Diagnostic and prognostic values of 2-[18F]FDG PET/CT in resectable thymic epithelial tumour

Improving the accuracy of prognosis for clinical stage I solid lung adenocarcinoma by radiomics models covering tumor per se and peritumoral changes on CT

Artificial intelligence on MRI for molecular subtyping of diffuse gliomas: feature comparison, visualization, and correlation between radiomics and deep learning

High-intensity focused ultrasound (HIFU) ablation versus surgical interventions for the treatment of symptomatic uterine fibroids: a meta-analysis