Top

European Archives of Oto-Rhino-Laryngology

Published in:

Open Access 01-05-2021 | Computed Tomography | Otology

Evaluation of artifacts of cochlear implant electrodes in cone beam computed tomography

Authors: Nicholas Bevis, Thomas Effertz, Dirk Beutner, Christian Gueldner

Published in: European Archives of Oto-Rhino-Laryngology | Issue 5/2021

Abstract

Purpose

Cone Beam Computed Tomography (CBCT) offers a valid alternative to conventional Computed Tomography (CT). A possible radiation dose reduction with the use of CBCT in postoperative imaging of CIs is of great importance. Whether the visualization of Cochlear Implant (CI) electrodes in CBCT correlates with the radiation dose applied was investigated in this study.

Methods

We compared the visualization quality of Contour Advance CIs to Straight CIs from Cochlear using CBCT with varying tube parameters on whole-head specimen.

Results

The internal diameter of the cochlea decreases from base to apex, resulting in a significantly different intracochlear positioning of the two tested CI models. While electrodes of the Contour Advance series are located close to the modiolus, thus closer to the spiral ganglion neurons, those of the Straight series are located further away. The artifact portion of the electrode amounts to 50–70% of the radiological diameter of the electrode. An increase in artifact portion from the base (electrode #1 approx. 50%) to the apex (electrode #20 approx. 70%) of the cochlea was observed. The visualization of electrodes in the medial and apical part of the cochlea is limited due to artifact overlapping. There was no correlation between the artifact size and the applied radiation dose.

Conclusion

The results indicate that a reduction of the radiation dose by up to 45% of the currently applied radiation dose of standard protocols would be possible. Investigations of the effects on subjective image quality still need to be performed.

DGHNOKHC: Cochlea-Implantat Versorgung einschließlich zentral-auditorischer Implantate. S2k Leitlinie. Registernummer 017 - 071, Stand: 02.05.2012.

Foggia MJ, Quevedo RV, Hansen MR (2019) Intracochlear fibrosis and the foreign body response to cochlear implant biomaterials. Laryngoscope Investig Otolaryngol 4(6):678–683. https://doi.org/10.1002/lio2.329CrossRefPubMedPubMedCentral

Carlson ML, Driscoll CL, Gifford RH et al (2011) Implications of minimizing trauma during conventional cochlear implantation. Otol Neurotol 32:962–968. https://doi.org/10.1097/MAO.0b013e3182204526CrossRefPubMedPubMedCentral

Labadie RF, Schefano AD, Holder JT, Dwyer RT, Rivas A, O'Malley MR, Noble JH, Dawant BM (2020) Use of intraoperative CT scanning for quality control assessment of cochlear implant electrode array placement. Acta Otolaryngol 140(3):206–211. https://doi.org/10.1080/00016489.2019.1698768CrossRefPubMed

Dragovic S, Stringer AK, Campbell L, Shaul C, O’Leary SJ, Briggs RJ (2018) Co-registration of cone beam CT and preoperative MRI for improved accuracy of electrode localization following cochlear implantation. Cochlear Implants Int 19(3):147–152. https://doi.org/10.1080/14670100.2017.1419548CrossRefPubMed

Antje A, Jan K, Thomas K, Roland L (2007) Quality control after insertion of the nucleus contour and contour advance electrode in adults. Ear Hear 28(2):75S–79S. https://doi.org/10.1097/AUD.0b013e318031542eCrossRef

Todt I, Rademacher G, Wagner J, Göpel F, Basta D, Haider E, Ernst A (2009) Evaluation of cochlear implant electrode position after a modified round window insertion by means of a 64-multislice CT. Acta Oto-Laryngol 129(9):966–970. https://doi.org/10.1080/00016480802495388CrossRef

Jerger J, Fifer R, Jenkins H, Mecklenburg D (1986) Stapedius reflex to electrical stimulation in a patient with a cochlear implant. Ann Otol Rhinol Laryngol 95(2):151–157. https://doi.org/10.1177/000348948609500208CrossRefPubMed

Komori M, Yamada K, Hinohira Y, Aritomo H, Yanagihara N (2013) Width of the normal facial canal measured by high-resolution cone-beam computed tomography. Acta Otolaryngol. https://doi.org/10.3109/00016489.2013.816443CrossRefPubMed

10.

Conte G, Scola E, Calloni S, Brambilla R, Campoleoni M, Lombardi L, Di Berardino F, Zanetti D, Gaini LM, Triulzi F, Sina C (2017) Flat panel angiography in the cross-sectional imaging of the temporal bone: assessment of image quality and radiation dose compared with a 64-section multisection CT scanner. Am J Neuroradiol 38(10):1998–2002. https://doi.org/10.3174/ajnr.A5302CrossRefPubMed

11.

Piergallini L, Scola E, Tuscano B et al (2018) Flat-panel CT versus 128-slice CT in temporal bone imaging: assessment of image quality and radiation dose. Eur J Radiol 106:106–113. https://doi.org/10.1016/j.ejrad.2018.07.013CrossRefPubMed

12.

Kyriakou Y, Kolditz D, Langner O, Krause J, Kalender W (2011) Digital volume tomography (DVT) and multislice spiral CT (MSCT): an objective examination of dose and image quality. Rofo 183(2):144–153CrossRef

13.

Al-Okshi A, Lindh C, Sale H, Gunnarsson M, Rohlin M (2015) Effective dose of cone beam CT (CBCT) of the facial skeleton: a systematic review. Br J Radiol 88(1045):20140658. https://doi.org/10.1259/bjr.20140658CrossRefPubMed

14.

Aschendorff A, Kubalek R, Hochmuth A, Bink A, Kurtz C, Lohnstein P et al (2004) Imaging procedures in cochlear implant patients--evaluation of different radiological techniques. In: Acta oto-laryngologica. Supplementum (552), pp 46–49

15.

Lehr H-A, Mankoff DA, Corwin D, Santeusanio G, Gown AM (1997) Application of photoshop-based image analysis to quantification of hormone receptor expression in breast cancer. J HistochemCytochem 45(11):1559–1565. https://doi.org/10.1177/002215549704501112CrossRef

16.

Jacques E, Buytaert J, Wells DM, Lewandowski M, Bennett MJ, Dirckx J et al (2013) MicroFilament Analyzer, an image analysis tool for quantifying fibrillar orientation, reveals changes in microtubule organization during gravitropism. Plant J Cell Mol Biol 74(6):1045–1058. https://doi.org/10.1111/tpj.12174CrossRef

17.

Erixon E, Högstorp H, Wadin K, Rask-Andersen H (2009) Variational anatomy of the human cochlea. OtolNeurotol 30:14–22. https://doi.org/10.1097/MAO.0b013e31818a08e8CrossRef

18.

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

19.

Diogo I, Franke N, Steinbach-Hundt S, Mandapathil M, Weiss R, Werner JA, Güldner C (2014) Differences of radiological artefacts in cochlear implantation in temporal bone and complete head. Cochlear Implants Int 15:112–117CrossRef

20.

Güldner C, Wiegand S, Weiß R, Bien S, Sesterhenn A, Teymoortash A, Diogo I (2012) Artifacts of the electrode in cochlea implantation and limits in analysis of deep insertion in cone beam tomography (CBT). EurArchOtorhinolaryngol 269:767–772

21.

Weisstanner C, Mantokoudis G, Huth M, Verma RK, Nauer C, Senn P et al (2015) Radiation dose reduction in postoperative computed position control of cochlear implant electrodes in lambs—an experimental study. Int J Pediatr Otorhinolaryngol 79(12):2348–2354. https://doi.org/10.1016/j.ijporl.2015.10.040CrossRefPubMed

22.

Wardrop P, Whinney D, Rebscher SJ, Roland JT, Luxford W, Leake PA (2005) A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. I: comparison of nucleus banded and nucleus contour electrodes. Hear Res 203:54–67CrossRef

23.

Skarzynski H, Matusiak M, Furmanek M, Pilka A, Wlodarczyk E, Oldak M, Skarzynski PH (2018) Measurement of cochlea and hearing preservation rate using slim straight electrode (CI422) and round window approach. Acta Otorhinolaryngol Ital 38(5):468–475. https://doi.org/10.14639/0392-100X-1579CrossRefPubMedPubMedCentral

24.

Shepherd RK, Hatsushika S, Clark GM (1993) Electrical stimulation of the auditory nerve: the effect of electrode position on neural excitation. Hear Res 66:108–120CrossRef

25.

Davis TJ, Zhang D, Gifford RH, Dawant BM, Labadie RF, Noble JH (2016) Relationship between electrode-to-modiolus distance and current levels for adults with cochlear implants. Otol Neurotol 37(1):31–37. https://doi.org/10.1097/MAO.0000000000000896CrossRefPubMedPubMedCentral

26.

Tykocinski M, Cohen LT, Pyman BC, Roland T, Treaba C, Palamara J et al (2000) Comparison of electrode position in the human cochlea using various perimodiolar electrode arrays. Am J Otol 21:205–211CrossRef

27.

Shaul C, Weder S, Tari S, Gerard JM, O'Leary SJ, Briggs RJ (2020) Slim, modiolar cochlear implant electrode: melbourne experience and comparison with the contour perimodiolar electrode. Otol Neurotol. https://doi.org/10.1097/MAO.0000000000002617CrossRefPubMed

28.

Videhult Pierre P, Eklöf M, Smeds H, Asp F (2019) Cochlear Implantation with the CI512 and CI532 s. Audiol Neurootol 24(6):299–308. https://doi.org/10.1159/000504592CrossRefPubMed

29.

Cuda D, Murri A (2019) Assessment of cochlear trauma and telemetry measures after cochlear implantation: a comparative study between Nucleus® CI512 and CI532 electrode arrays. Audiol Res 9(1):223. https://doi.org/10.4081/audiores.2019.223CrossRefPubMedPubMedCentral

30.

Cuda D, Murri A (2017) Cochlear implantation with the nucleus slim modiolar electrode (CI532): a preliminary experience. Eur Arch Otorhinolaryngol 274(12):4141–4148. https://doi.org/10.1007/s00405-017-4774-6CrossRefPubMed

31.

Abd El Aziz TT, El Fiky L, Shalaby MH, Essam A (2019) Radiological evaluation of inner ear trauma after cochlear implant surgery by cone beam CT(CBCT). Eur Arch Otorhinolaryngol 276(10):2697–2703. https://doi.org/10.1007/s00405-019-05507-4CrossRefPubMed

32.

Alkadhi H, Leschka S, Stolzmann P, Scheffel H (2011) Wie funktioniert CT? Eine Einführung in Physik, Funktionsweise und klinische Anwendungen der Computertomographie. Springer-Verlag GmbH, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-17803-0CrossRef

Title: Evaluation of artifacts of cochlear implant electrodes in cone beam computed tomography
Authors: Nicholas Bevis
Thomas Effertz
Dirk Beutner
Christian Gueldner
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Digital Volume Tomography
Digital Volume Tomography
Cochlear Implant
Published in: European Archives of Oto-Rhino-Laryngology / Issue 5/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06198-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of artifacts of cochlear implant electrodes in cone beam computed tomography

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2021

Gigantic paranasal sinuses osteomas: clinical features, management considerations, and long-term outcomes

Three-dimensional modeling and automatic analysis of the human nasal cavity and paranasal sinuses using the computational fluid dynamics method

Contribution of narrow band imaging in delineation of laryngopharyngeal superficial cancer spread: a prospective study

Effects of hyaluronic acid-collagen nanofibers on early wound healing in vocal cord trauma

Grading system and surgical approaches for endolymphatic sac tumors

Endoscopic-assisted pediatric transcutaneous bone-anchored hearing implant: how I do it