Radiation dose saving through the use of cone-beam CT in hearing-impaired patients

Faccioli, Niccolò; Barillari, Marco; Guariglia, Stefania; Zivelonghi, Emanuele; Rizzotti, A.; Cerini, Roberto; Mucelli, Roberto Pozzi

doi:10.1007/s11547-009-0462-y

Cited by 48 publications

(25 citation statements)

References 21 publications

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“…Successful identification of the CI electrode scalar position has also been reported in temporal bone studies [Husstedt et al, 2002;Ruivo et al, 2009;Cushing et al, 2012;Saeed et al, 2014] and in vivo postoperative studies [Aschendorff et al, 2007]. Another important advantage of FPV CT for in vivo applications is that it offers reduced exposure to ionizing radiation compared to conventional helical high-resolution computed tomography [Faccioli et al, 2009;Ruivo et al, 2009].…”

Section: Introductionmentioning

confidence: 87%

Clinical investigation of the Nucleus Slim Modiolar Electrode

et al. 2017

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Aims: The Nucleus CI532 cochlear implant incorporates a new precurved electrode array, i.e., the Slim Modiolar electrode (SME), which is designed to bring electrode contacts close to the medial wall of the cochlea while avoiding trauma due to scalar dislocation or contact with the lateral wall during insertion. The primary aim of this prospective study was to determine the final position of the electrode array in clinical cases as evaluated using flat-panel volume computed tomography. Methods: Forty-five adult candidates for unilateral cochlear implantation were recruited from 8 centers. Eleven surgeons attended a temporal bone workshop and received further training with a transparent plastic cochlear model just prior to the first surgery. Feedback on the surgical approach and use of the SME was collected via a questionnaire for each case. Computed tomography of the temporal bone was performed postoperatively using flat-panel digital volume tomography or cone beam systems. The primary measure was the final scalar position of the SME (completely in scala tympani or not). Secondly, medial-lateral position and insertion depth were evaluated. Results: Forty-four subjects received a CI532. The SME was located completely in scala tympani for all subjects. Pure round window (44% of the cases), extended round window (22%), and inferior and/or anterior cochleostomy (34%) approaches were successful across surgeons and cases. The SME was generally positioned close to the modiolus. Overinsertion of the array past the first marker tended to push the basal contacts towards the lateral wall and served only to increase the insertion depth of the first electrode contact without increasing the insertion depth of the most apical electrode. Complications were limited to tip fold-overs encountered in 2 subjects; both were attributed to surgical error, with both reimplanted successfully. Conclusions: The new Nucleus CI532 cochlear implant with SME achieved the design goal of producing little or no trauma as indicated by consistent scala tympani placement. Surgeons should be carefully trained to use the new deployment method such that tip fold-overs and over insertion may be avoided.

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Section: Introductionmentioning

confidence: 87%

Clinical investigation of the Nucleus Slim Modiolar Electrode

et al. 2017

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“…[17][18][19][20][21][22][23] When evaluating the CT scan, several points need to be considered. An axial plane view CT scan, imaging the mastoid portion of the facial nerve, should be included as well as a coronal view, which is especially necessary in patients with malformations.…”

Section: Preoperative Radiological Assessmentmentioning

confidence: 99%

Consensus Statement on Round Window Vibroplasty

Beltrame

Todt

Sprinzl

et al. 2014

Ann Otol Rhinol Laryngol

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Round window (RW) vibroplasty has been established as a reliable procedure that produces good and stable results for patients with conductive or mixed hearing loss. The experience gained over the past few years of the authors' more than 200 implantations has led to consensus on several key points: (1) a wide and bloodless access to the middle ear with facial nerve monitoring, (2) the careful and correct identification and exposure of the round window membrane, (3) a good setup for efficient energy transition of the FMT, namely, perpendicular placement of the FMT with no contact to bone and the placement of cartilage behind the FMT to create a preloaded "spring" function, and (4) 4 points of FMT fixation: a rim of the round window bony overhang left intact both anterior and posterior to the FMT, conductor link stabilization, and cartilage behind the FMT. In addition, the FMT should be covered with soft tissue.

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“…Faccioli et al (15) found that the effective dose of CBCT was almost 3 times less than MSCT. Ruivo et al (16) argued that CBCT provides equivalent information to 16-slice CT in temporal bone imaging, with a significant reduction in effective radiation dose.…”

Section: Discussionmentioning

confidence: 99%