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Updated: Feb 15, 2026
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Co-registration of cone beam CT and preoperative MRI for improved accuracy of electrode localization following
A S Dragovic1, A K Stringer1, L Campbell2
1a Department of Otolaryngology , The Royal Victorian Eye and Ear Hospital , 32 Gisborne St, East Melbourne 3002 , Victoria , Australia.
Objectives:
To investigate the clinical usefulness and practicality of co-registration of Cone Beam CT (CBCT) with preoperative Magnetic Resonance Imaging (MRI) for intracochlear localization of electrodes after cochlear implantation.
Methods:
Images of 20 adult patients who underwent CBCT after implantation were co-registered with preoperative MRI scans. Time taken for co-registration was recorded. The images were analysed by clinicians of varying levels of expertise to determine electrode position and ease of interpretation.
Results:
After a short learning curve, the average co-registration time was 10.78 minutes (StdDev 2.37). All clinicians found the co-registered images easier to interpret than CBCT alone. The mean concordance of CBCT vs. co-registered image analysis between consultant otologists was 60% (17-100%) and 86% (60-100%), respectively. The sensitivity and specificity for CBCT to identify Scala Vestibuli insertion or translocation was 100 and 75%, respectively. The negative predictive value was 100%.
Discussion:
CBCT should be performed following adult cochlear implantation for audit and quality control of surgical technique. If SV insertion or translocation is suspected, co-registration with preoperative MRI should be performed to enable easier analysis. There will be a learning curve for this process in terms of both the co-registration and the interpretation of images by clinicians.
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