The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy
Although malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement....
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/11/9/4144 |
| _version_ | 1827693555259277312 |
|---|---|
| author | Ohad Cohen Jean-Yves Sichel Chanan Shaul Itay Chen J. Thomas Roland Ronen Perez |
| author_facet | Ohad Cohen Jean-Yves Sichel Chanan Shaul Itay Chen J. Thomas Roland Ronen Perez |
| author_sort | Ohad Cohen |
| collection | DOAJ |
| description | Although malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement. The purpose of this report was to assess the incidence and describe cases in which intraoperative plain radiographs detected a malpositioned array. Intraoperative anti-Stenver’s view plain X-rays are conducted routinely in all CI surgeries in our tertiary center before awakening the patient and breaking the sterile field. Data of patients undergoing 399 CI surgeries were retrospectively analyzed. A total of 355 had normal inner ear and temporal bone anatomy. Patients with intra or extracochlear malpositioned electrode arrays demonstrated in the intraoperative X-ray were described. There were four cases of electrode array malposition out of 355 implantations with normal anatomy (1.1%): two tip fold-overs, one extracochlear placement and one partial insertion. All electrodes were reinserted immediately; repeated radiographs were normal and the patients achieved good hearing function. Intraoperative plain anti-Stenver’s view X-rays are valuable to confirm electrode array location, allowing correction before the conclusion of surgery. These radiographs are cheaper, faster, and emit much less radiation than other imaging options, making them a viable cost-effective tool in patients with normal anatomy. |
| first_indexed | 2024-03-10T11:46:10Z |
| format | Article |
| id | doaj.art-5af0570231804cbcb7fb7b3450e9eb72 |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T11:46:10Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-5af0570231804cbcb7fb7b3450e9eb722023-11-21T18:03:38ZengMDPI AGApplied Sciences2076-34172021-04-01119414410.3390/app11094144The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal AnatomyOhad Cohen0Jean-Yves Sichel1Chanan Shaul2Itay Chen3J. Thomas Roland4Ronen Perez5Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, IsraelDepartment of Otolaryngology-Head & Neck Surgery, NYU School of Medicine, New York, NY 10016, USAFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, IsraelAlthough malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement. The purpose of this report was to assess the incidence and describe cases in which intraoperative plain radiographs detected a malpositioned array. Intraoperative anti-Stenver’s view plain X-rays are conducted routinely in all CI surgeries in our tertiary center before awakening the patient and breaking the sterile field. Data of patients undergoing 399 CI surgeries were retrospectively analyzed. A total of 355 had normal inner ear and temporal bone anatomy. Patients with intra or extracochlear malpositioned electrode arrays demonstrated in the intraoperative X-ray were described. There were four cases of electrode array malposition out of 355 implantations with normal anatomy (1.1%): two tip fold-overs, one extracochlear placement and one partial insertion. All electrodes were reinserted immediately; repeated radiographs were normal and the patients achieved good hearing function. Intraoperative plain anti-Stenver’s view X-rays are valuable to confirm electrode array location, allowing correction before the conclusion of surgery. These radiographs are cheaper, faster, and emit much less radiation than other imaging options, making them a viable cost-effective tool in patients with normal anatomy.https://www.mdpi.com/2076-3417/11/9/4144intraoperative plain X-rayanti-Stenver’s viewcochlear implantationelectrode array malpositiontip fold-over |
| spellingShingle | Ohad Cohen Jean-Yves Sichel Chanan Shaul Itay Chen J. Thomas Roland Ronen Perez The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy Applied Sciences intraoperative plain X-ray anti-Stenver’s view cochlear implantation electrode array malposition tip fold-over |
| title | The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy |
| title_full | The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy |
| title_fullStr | The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy |
| title_full_unstemmed | The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy |
| title_short | The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy |
| title_sort | importance of intraoperative plain radiographs during cochlear implant surgery in patients with normal anatomy |
| topic | intraoperative plain X-ray anti-Stenver’s view cochlear implantation electrode array malposition tip fold-over |
| url | https://www.mdpi.com/2076-3417/11/9/4144 |
| work_keys_str_mv | AT ohadcohen theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT jeanyvessichel theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT chananshaul theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT itaychen theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT jthomasroland theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT ronenperez theimportanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT ohadcohen importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT jeanyvessichel importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT chananshaul importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT itaychen importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT jthomasroland importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy AT ronenperez importanceofintraoperativeplainradiographsduringcochlearimplantsurgeryinpatientswithnormalanatomy |