Clinical values and advances in computed tomography evaluation after cochlear implantation

Abstract

Cochlear implantation has been a standard rehabilitation for children and adult patients with severe to profound sensorineural deafness. The intracochlear localization of the electrode array is one of the key factors related to the postoperative auditory and speech outcomes. Preservation of the residual hearing is related to the trauma to the inner ear structures caused in the insertion process. Optimal insertion depth and positioning of the electrode array is important for frequency discrimination. The post-operative position of the electrode array is evaluated by using plain X ray or computed tomography (CT). Compared to the plain X ray, CT produces three-dimensional (3D) imaging. With the application of post-operative CT evaluation, the integrity of the electrode array can be verified for surgical safety and improving programming accuracy. Different 3D reconstruction techniques and methods based on the post-operative CT imaging have been proposed to facilitate the precise recognition of position of each electrode, thus helpful to evaluate the possible insertion trauma to inner ear structures and the potential effect on auditory and speech outcomes. The post-operative CT evaluation has helped the electrode array design, brought progress to the soft surgery procedure and promoted new technologies such as robotic surgery and navigation. Therefore, it is getting more and more attention. This article reviews the clinical application values and the progress of techniques in post-operative CT evaluation of cochlear implantation.

Keywords

• cochlear implantation
• computed tomography (ct)
• multiplanar reconstruction
• 3d fusion reconstruction