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79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

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Importance of intra-operative imaging during cochlear implantation

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  • corresponding author Pethe Wolfram - HNO-Klinik, AMEOS Klinikum, Halberstadt, Germany
  • Mathias Hey - HNO-Klinik, AMEOS Klinikum, Halberstadt, Germany
  • Jörg Langer - HNO-Klinik, AMEOS Klinikum, Halberstadt, Germany
  • Klaus Begall - HNO-Klinik, AMEOS Klinikum, Halberstadt, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno14

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2008/08hno14.shtml

Published: July 8, 2008

© 2008 Wolfram et al.
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Outline

Text

Radiological evaluation of electrode placement during cochlear implantation is a standard procedure. Besides classic x-ray imaging different methods like 3D rotational X-ray, computed tomography and CT-MRI data fusion methods are described. Electrophysiological methods like neural response telemetry (ART, NRI, NRT) and stapedius reflex testing are used to evaluate connection between electrode and auditory nerve. They are also proven to give information about correct electrode placement. Accordingly it has to be reconsidered if single surly interesting methods can be waived.

The importance is shown using retrospective data of 415 cochlear implant-operations and a case report. Regularly a classic cochlear view x-ray image has been performed in every single case. In addition impedances had been measured and stapedius reflex had been tested. Since 2000 a NRT-measurement (ART since 2005) has been performed routinely.

In two single cases the implant has been removed after stylet-problems during operation prior intra-operative imaging. One Revision had been done due to short circuit problems of the electrode that had been detected by impedance measurement. Solely in a single case a misdirection of the electrode had been detected by intra-operative imaging while impedances had been correct and stapedius reflexes had been verified. An explantation and reimplantation had been done the same day. Despite high costs for intra-operative imaging and improved electrophysiological methods an intra-operative visualisation of the correct electrode place is absolutely necessary to ensure best operative results.