Virtual cochlear implantation for personalized rehabilitation of profound hearing loss

Schurzig, Daniel; Repp, Felix; Timm, Max; Batsoulis, Cornelia; Lenarz, Thomas; Kral, Andrej

doi:10.1016/j.heares.2022.108687

Cited by 7 publications

(9 citation statements)

References 67 publications

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“…The recordings took place at discrete electrode insertion steps using the most apical contact C1. On the left panels these steps are visualized by means of the assumed electrode insertion depth as calculated from the preoperative clinical imaging data with the recording contact being highlighted ( Schurzig et al, 2023 ). The blue line represents the location in the cochlea where the 500 Hz characteristic frequency region is located.…”

Section: Resultsmentioning

confidence: 99%

“…A detailed description of this tracing procedure is given in Timm et al (2018 ). In order to determine the location of the electrode during insertion, the algorithm described in Schurzig et al (2023 ) was used and is hence only described briefly in the following: based on the LW tracing, the 3D shape of the LW was reconstructed within the consensus coordinate system proposed in Verbist et al (2010 ) and enhanced to a full reconstruction of the cochlear lumina using the IC cross-section derived in Schurzig et al (2021 ). The electrode array and insertion angle specific average distance between LW and array (see also Salcher et al, 2021 ) were then used to estimate the path of the array inside the scala tympani of the patient specific 3D cochlear reconstruction.…”

Section: Methodsmentioning

confidence: 99%

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Intracochlear Recording of Electrocochleography During and After Cochlear Implant Insertion Dependent on the Location in the Cochlea

Haumann,

Timm,

Büchner

et al. 2024

Trends in Hearing

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To preserve residual hearing during cochlear implant (CI) surgery it is desirable to use intraoperative monitoring of inner ear function (cochlear monitoring). A promising method is electrocochleography (ECochG). Within this project the relations between intracochlear ECochG recordings, position of the recording contact in the cochlea with respect to anatomy and frequency and preservation of residual hearing were investigated. The aim was to better understand the changes in ECochG signals and whether these are due to the electrode position in the cochlea or to trauma generated during insertion. During and after insertion of hearing preservation electrodes, intraoperative ECochG recordings were performed using the CI electrode (MED-EL). During insertion, the recordings were performed at discrete insertion steps on electrode contact 1. After insertion as well as postoperatively the recordings were performed at different electrode contacts. The electrode location in the cochlea during insertion was estimated by mathematical models using preoperative clinical imaging, the postoperative location was measured using postoperative clinical imaging. The recordings were analyzed from six adult CI recipients. In the four patients with good residual hearing in the low frequencies the signal amplitude rose with largest amplitudes being recorded closest to the generators of the stimulation frequency, while in both cases with severe pantonal hearing losses the amplitude initially rose and then dropped. This might be due to various reasons as discussed in the following. Our results indicate that this approach can provide valuable information for the interpretation of intracochlearly recorded ECochG signals.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Intracochlear Recording of Electrocochleography During and After Cochlear Implant Insertion Dependent on the Location in the Cochlea

Haumann,

Timm,

Büchner

et al. 2024

Trends in Hearing

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“…1A). It was also demonstrated in a previous study that these tracings can then be used to reconstruct the corresponding cochlear helices and subsequently extract various parameters of interest (32,33). This was done within the present study as well: using Matlab (version R2018a, MathWorks, Natick, MA), the 3D lateral wall profiles were reconstructed, and the basal cochlear diameter A , width B, and height H , the basal turn length BTL LW , as well as the total cochlear duct length CDL LW along the LW were computed from the reconstructed LW contour.…”

Section: Methodsmentioning

confidence: 99%

Correlation of Scalar Cochlear Volume and Hearing Preservation in Cochlear Implant Recipients with Residual Hearing

Räth,

Schurzig,

Timm

et al. 2024

Otol Neurotol

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Objective Preservation of residual hearing is one of the main goals in cochlear implantation. There are many factors that can influence hearing preservation after cochlear implantation. The purpose of the present study was to develop an algorithm for validated preoperative cochlear volume analysis and to elucidate the role of cochlear volume in preservation of residual hearing preservation after atraumatic cochlear implantation. Study design Retrospective analysis. Setting Tertiary referral center. Patients A total of 166 cochlear implant recipients were analyzed. All patients were implanted with either a MED-EL (Innsbruck, Austria) FLEXSOFT (n = 3), FLEX28 (n = 72), FLEX26 (n = 1), FLEX24 (n = 41), FLEX20 (n = 38), or FLEX16 (n = 11, custom made device) electrode array through a round window approach. Main outcome measures: Cochlear volume as assessed after manual segmentation of cochlear cross-sections in cone beam computed tomography, and preservation of residual hearing 6 months after implantation were analyzed. The association between residual hearing preservation and cochlear volume was then assessed statistically. Results Rapid and valid cochlear volume analysis was possible using the individual cross-sections and a newly developed and validated algorithm. Cochlear volume had the tendency to be larger in patients with hearing preservation than in those with hearing loss. Significant correlations with hearing preservation could be observed for the basal width and length of the basal turn. Conclusions Preservation of residual hearing after cochlear implantation may depend on cochlear volume but appears to be influenced more strongly by other cochlear dimensions.

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“…Three different methods were tested in characterization of the LW in these data sets: direct manual delineation of the cochlear wall (26) as well as estimations based on a multiple linear regression scaling (RS) model (31) and elliptic-circular approximation (ECA) (24,32). For direct manual delineation, OsiriX MD (Pixmeo SARL, Bernex, Switzerland) was used to trace the LW within imaging data sets starting from the center of the round window up to the most apical point within the helicotrema region, as depicted in Figure 1A.…”

Section: Methodsmentioning

confidence: 99%

“…All LW tracings were imported into MATLAB (version R2018a; MathWorks, Natick, MA) and used to reconstruct the LW contour according to Escudé et al (23). For the estimation methods, the LW contour was reconstructed based on the respective algorithm (31,32). For the ECA reconstruction, the numerical version of the model was chosen to derive not only length values but also information about the individual size and shape of the cochlear spiral.…”

Section: Error Evaluationmentioning

confidence: 99%

The Dependency of Cochlear Lateral Wall Measurements on Observer and Imaging Type

Sieber,

Timm,

Weller

et al. 2023

Otol Neurotol

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Hypothesis Assessment techniques for the cochlear spatial lateral wall are associated with inter-rater variability, but derived clinical recommendations nonetheless offer value for individualized electrode selection. Background Anatomical variations influence the location of cochlear implant electrodes inside the cochlea. Preoperative planning allows individualization of the electrode based on characterization of the bony lateral wall. Methods The study used publicly available digitized temporal bones based on microslicing and computed tomography. Four experienced observers assessed the lateral wall applying manual tracing, linear regression scaling and elliptic-circular approximation methods in all modalities. Radial and height differences were computed in 90-degree steps from the round window center to the apex. Total length, total angular length, and tonotopic frequencies were computed for each reconstruction. Results Differences were found most pronounced between assessment methods in vertical direction across observers and imaging modalities. One of the five anatomies was consistently found to be of shorter cochlear duct length with estimation techniques yielding more conservative results compared with manual tracings. Conclusions Assessment techniques for the bony lateral wall yield method, observer, and image modality related deviations. Automation of the anatomical characterization may offer potential in minimizing inaccuracies. Nonetheless, observers were consistently able to detect a smaller inner ear demonstrating the ability of current methods to contribute to an optimized choice of electrodes based on individual patient anatomy.

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Virtual cochlear implantation for personalized rehabilitation of profound hearing loss

Cited by 7 publications

References 67 publications

Intracochlear Recording of Electrocochleography During and After Cochlear Implant Insertion Dependent on the Location in the Cochlea

Intracochlear Recording of Electrocochleography During and After Cochlear Implant Insertion Dependent on the Location in the Cochlea

Correlation of Scalar Cochlear Volume and Hearing Preservation in Cochlear Implant Recipients with Residual Hearing

The Dependency of Cochlear Lateral Wall Measurements on Observer and Imaging Type

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