Artikel
3-dimensional C-arm technology – a well suited tool for intraoperative imaging in cochlear implantation
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Autoren
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Diana Arweiler-Harbeck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
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Kerstin Büchsenschütz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
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Pia Hasskamp
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
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Wieland Beer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
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Adrian Ringelstein
- Institute of Radiology, University Hospital Essen, Essen, Germany
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Stephan Lang
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
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Lena Lochner
- Ziehm Imaging GmbH, Erlangen, Germany
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Eva Maria Ilg
- Ziehm Imaging GmbH, Erlangen, Germany
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Judith Arnolds
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Essen, Germany
| Veröffentlicht: | 7. September 2016 |
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Gliederung
Text
Introduction: Postoperative imaging after cochlear implantation by either computed tomography (CT) digital volume tomography (DVT) or cochlear view (CV) meanwhile is established for documentation of correct position of the electrode array. However there are only very few ways for intraoperative straightforward imaging, which often is mandatory in anatomic malformation as well as for determination of correct electrode position. The recent processing in the field of 3 dimensional C-arm technology offers a new method of intraoperative imaging of the petrous bone and was investigated in this trial.
Patients and methods: In preliminary petrous bone studies a concrete ray window adapted to the size of the petrous bone was determined and imaging quality of 4 different electrode arrays was evaluated. Effective radiation dose could be reduced to less than 1mSV. In a prospective setting the feasibility of correct position identification of array and electrodes, as well as length and angle of insertion and correlation to the size of the cochlear were investigated in 40 consecutively operated patients by means of a recently developed 3 dimensional C-arm.
Results: After adaptation of patient and operating table and adjustment of the 3 D C-arm, exact position of single electrodes and electrode array within the cochlear could easily be identified in more than 90% of cases. Intraoperative investigation time is less than 10 minutes and scanning time in apnoea about 70 seconds.
Conclusion: In conclusion the investigated 3-dimensional C-arm is well suited for exact intraoperative position control of electrode array in cochlear implantation, even under sterile conditions, providing exact anatomic information and a low radiation dose in short scanning time.
