Evaluation of Rigid Cochlear Models for Measuring Cochlear Implant Electrode Position

Objective: To investigate the accuracy of rigid cochlear models in measuring intra-cochlear positions of cochlear implant (CI) electrodes. Patients: Ninety three adults who had undergone CI and pre- and postoperative computed tomographic (CT) imaging. Main Outcome Measures: Seven rigid models of cochlear anatomy were constructed using micro-CTs of cochlear specimens. Using each of the seven models, the position of each electrode in each of the 98 ears in our dataset was measured as its depth along the length of the cochlea, its distance to the basilar membrane, and its distance to the modiolus. Cochlear duct length was also measured using each model. Results: Standard deviation (SD) across rigid cochlear models in measures of electrode depth, distance to basilar membrane, distance to modiolus, and length of the cochlear duct at two turns were 0.68, 0.11, 0.15, and 1.54 mm. Comparing the estimated position of the electrodes with respect to the basilar membrane, i.e., deciding whether an electrode was located within the scala tympani (ST) or the scala vestibuli (SV), there was not a unanimous agreement between the models for 19% of all the electrodes. With respect to the modiolus, each electrode was classified into one of the three groups depending on its modiolar distance: close, medium, and far. Rigid models did not unanimously agree on modiolar distance for approximately 50% of the electrodes tested. Conclusions: Inter-model variance of rigid cochlear models exists, demonstrating that measurements made using rigid cochlear models are limited in terms of accuracy because of non-rigid inter-subject variations in cochlear anatomy.

[1]  Benoit M Dawant,et al.  Assessment of Electrode Placement and Audiological Outcomes in Bilateral Cochlear Implantation , 2011, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[2]  E. Neri,et al.  3-D CT and MRI co-registration in the assessment of cochlear implantation. , 2005, Medical science monitor : international medical journal of experimental and clinical research.

[3]  A Aschendorff,et al.  Imaging procedures in cochlear implant patients – evaluation of different radiological techniques , 2004, Acta oto-laryngologica.

[4]  Helge Rask-Andersen,et al.  Variational Anatomy of the Human Cochlea: Implications for Cochlear Implantation , 2009, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[5]  Benoit M. Dawant,et al.  Clinical Evaluation of an Image-Guided Cochlear Implant Programming Strategy , 2014, Audiology and Neurotology.

[6]  S. Schmerber,et al.  Scalar Localization by Cone-Beam Computed Tomography of Cochlear Implant Carriers: A Comparative Study Between Straight and Periomodiolar Precurved Electrode Arrays , 2015, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[7]  Luca Ferrarini,et al.  Anatomic Considerations of Cochlear Morphology and Its Implications for Insertion Trauma in Cochlear Implant Surgery , 2009, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[8]  Benoit M Dawant,et al.  Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes , 2014, The Laryngoscope.

[9]  Margaret W Skinner,et al.  Role of Electrode Placement as a Contributor to Variability in Cochlear Implant Outcomes , 2008, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[10]  Benoit M. Dawant,et al.  Automatic Graph-Based Localization of Cochlear Implant Electrodes in CT , 2015, MICCAI.

[11]  Kumiko Yukawa,et al.  Effects of Insertion Depth of Cochlear Implant Electrodes upon Speech Perception , 2004, Audiology and Neurotology.

[12]  Benoit M. Dawant,et al.  Image-Guidance Enables New Methods for Customizing Cochlear Implant Stimulation Strategies , 2013, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[13]  Thomas Lenarz,et al.  Variations in microanatomy of the human cochlea , 2014, The Journal of comparative neurology.

[14]  Thomas Klenzner,et al.  Quality Control After Insertion of the Nucleus Contour and Contour Advance Electrode in Adults , 2007, Ear and hearing.

[15]  Benoit M Dawant,et al.  Analysis of Intersubject Variations in Intracochlear and Middle Ear Surface Anatomy for Cochlear Implantation , 2013, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[16]  Benoit M. Dawant,et al.  Automatic Localization of Cochlear Implant Electrodes in CT , 2014, MICCAI.

[17]  J. Stuelpnagel,et al.  A Least Squares Estimate of Satellite Attitude (Grace Wahba) , 1966 .

[18]  Johan H M Frijns,et al.  Multisection CT as a valuable tool in the postoperative assessment of cochlear implant patients. , 2005, AJNR. American journal of neuroradiology.

[19]  Margaret W Skinner,et al.  In Vivo Estimates of the Position of Advanced Bionics Electrode Arrays in the Human Cochlea , 2007, The Annals of otology, rhinology & laryngology. Supplement.

[20]  Karen M Mispagel,et al.  Factors Affecting Open-Set Word Recognition in Adults With Cochlear Implants , 2013, Ear and hearing.

[21]  Margaret W. Skinner,et al.  CT-Derived Estimation of Cochlear Morphology and Electrode Array Position in Relation to Word Recognition in Nucleus-22 Recipients , 2002, Journal of the Association for Research in Otolaryngology.

[22]  Benoit M Dawant,et al.  Initial Results With Image-guided Cochlear Implant Programming in Children , 2016, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[23]  Omid Majdani,et al.  Automatic Segmentation of Intracochlear Anatomy in Conventional CT , 2011, IEEE Transactions on Biomedical Engineering.

[24]  W. Grolman,et al.  Ex Vivo and In Vivo Imaging of the Inner Ear at 7 Tesla MRI , 2014, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.