A novel intraoperative imaging tool to follow the cochlear implant electrode array insertion dynamics

Area of Science:

• Otolaryngology
• Medical Imaging
• Neurosurgery

Background:

• Cochlear implants convert sound waves to electrical signals for hearing rehabilitation.
• Optimal outcomes depend on precise electrode placement and minimal cochlear damage.
• Routine electrophysiological tests may not detect abnormal electrode positions.

Purpose of the Study:

• To present a novel application of hybrid operating room technology for cochlear implantation.
• To evaluate the utility of intraoperative imaging in guiding electrode placement.
• To assess the benefits in patients with cochlear malformations.

Main Methods:

• Simultaneous bilateral cochlear implantation using perimodiolar electrode arrays.
• Utilized a Siemens Artis pheno C-arm robot with digital subtraction angiography for real-time imaging.
• Employed fluoroscopy and volume tomography during electrode insertion.

Main Results:

• Intraoperative imaging enabled dynamic tracking and static verification of electrode array position.
• Routine postoperative imaging was replaced by real-time intraoperative assessment.
• Abnormal electrode positions were corrected in the same surgical session, avoiding revision surgery.

Conclusions:

• Hybrid operating rooms facilitate well-controlled, minimally invasive cochlear implant procedures.
• Intraoperative imaging is crucial for malformed cochleae and challenging electrode insertions.
• This technique enhances surgical precision and patient safety.