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Updated: Sep 18, 2025
Enhancing Electrode Location Assessment in Cochlear Implantation via Computed Tomography Image Fusion
Published on: January 17, 2025
Estimation of Angular Insertion Depth of a Cochlear Implant Electrode Array: Three-Dimensional Reconstruction Versus
Irumee Pai1,2, Aditi Shetty1, Gowri Pradeep3
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Objectives:
The primary objective was to determine which of the following angular insertion depth (AID) estimation methods showed the strongest correlation with the postoperative AID (AIDpostop) of a lateral wall (LW) electrode: the Escudé formula, based on the largest distance from the round window (RW) to the LW (distance A); the elliptic-circular approximation (ECA) method, based on both distance A and the perpendicular distance (distance B); and a three-dimensional (3D) reconstruction method. The secondary objective was to assess the impact of using the actual electrode insertion length on the evaluation of AID estimation methods.
Methods:
This study included 45 cochleae implanted with the Advanced Bionics SlimJ electrode, with all 16 active electrode contacts positioned intracochlear. Distance A, distance B, and a 3D reconstruction along the LW were evaluated on preoperative magnetic resonance imaging using 3D Slicer. The AIDpostop and insertion length were assessed using cone-beam computed tomography. Two sets of estimated AID values were obtained: assuming a perfect 23-mm insertion length with the reference electrode at the RW (AID23mm); and using the actual insertion length (AIDinsertionlength). Spearman's rank correlation coefficient was used to assess the association between the estimated AID values and AIDpostop.
Results:
A moderately positive correlation was observed between AID23mm and AIDpostop for all three approaches, with no statistically significant differences among them (rs=0.410-0.579). When the analysis was repeated using AIDinsertionlength, the strength of the correlation with AIDpostop increased significantly for all three methods, with the 3D reconstruction method showing a stronger correlation (rs=0.952) than the Escudé formula (rs=0.734) or the ECA method (rs=0.787) (P<0.001).
Conclusion:
The 3D reconstruction approach has the potential to improve prediction of the AID for LW electrode arrays compared to spiral formulae based on 2D cochlear dimensions. Accurate assessment of the actual insertion length is important for the proper evaluation of AID estimation methods.
