Cone-beam computed tomography in children with cochlear implants: The effect of electrode array position on ECAP

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• 作者：Marine Lathuilliè ; re^a ; ^{m-lathuilliere@chu-montpellier.fr} ; Fanny Merklen^a ; Jean-Pierre Piron^a ; Marielle Sicard^a ; Franç ; oise Villemus^a ; Nicolas Menjot de Champfleur^b ; Fré ; dé ; ric Venail^a ; Alain Uziel^a ; Michel Mondain^a
• 关键词：Cone-beam CT ; Children ; Cochlear implant ; ECAP ; Insertion angle ; Electrode array
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：92
• 期：Complete
• 页码：27-31
• 全文大小：388 K
• 卷排序：92

文摘

To assess the feasibility of using cone-beam computed tomography (CBCT) in young children with cochlear implants (CIs) and study the effect of intracochlear position on electrophysiological and behavioral measurements.MethodsA total of 40 children with either unilateral or bilateral cochlear implants were prospectively included in the study. Electrode placement and insertion angles were studied in 55 Cochlear® implants (16 straight arrays and 39 perimodiolar arrays), using either CBCT or X-ray imaging. CBCT or X-ray imaging were scheduled when the children were leaving the recovery room. We recorded intraoperative and postoperative neural response telemetry threshold (T-NRT) values, intraoperative and postoperative electrode impedance values, as well as behavioral T (threshold) and C (comfort) levels on electrodes 1, 5, 10, 15 and 20.ResultsCBCT imaging was feasible without any sedation in 24 children (60%). Accidental scala vestibuli insertion was observed in 3 out of 24 implants as assessed by CBCT. The mean insertion angle was 339.7°±35.8°. The use of a perimodiolar array led to higher angles of insertion, lower postoperative T-NRT, as well as decreased behavioral T and C levels. We found no significant effect of either electrode array position or angle of insertion on electrophysiological data.ConclusionCBCT appears to be a reliable tool for anatomical assessment of young children with CIs.Intracochlear position had no significant effect on the electrically evoked compound action potential (ECAP) threshold. Our CBCT protocol must be improved to increase the rate of successful investigations.