Effectiveness of skull X-RAY to determine cochlear implant insertion depth
Abstract Background Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however it...
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| Format: | Article |
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SAGE Publishing
2018-09-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-018-0304-9 |
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| author | Vinay Fernandes Yiqiao Wang Robert Yeung Sean Symons Vincent Lin |
| author_facet | Vinay Fernandes Yiqiao Wang Robert Yeung Sean Symons Vincent Lin |
| author_sort | Vinay Fernandes |
| collection | DOAJ |
| description | Abstract Background Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however its effectiveness has not been well established. Our primary objective was to assess the accuracy of post-op skull X-RAYs to determine insertion depth, compared to CT as the gold standard. Secondary objectives were to compare experience level of raters and different skull X-RAY views. Methods Thirteen patients with Advanced Bionic HiRes 90 K implants, and post-operative temporal bone CT scans were selected from the CI database at Sunnybrook Health Sciences Centre. Medical students, otology fellows, and CI surgeons evaluated insertion depths on post-op skull X-RAYs, while neuroradiologists evaluated CT scans. Descriptive statistics, regression analysis, and paired t-tests were used to compare the two types of imaging. Results X-RAYs and CTs provided an equivalent mean insertion depth of 337 degrees (p = 0.93), a mean difference of − 0.9 degrees and a standard deviation of paired differences of 43 degrees. Although means were similar across rater groups, CI surgeons (45 degrees) had the lowest standard deviation of paired differences. Comparing X-RAY views, Caldwell (29 degrees) had less variation than Towne (59 degrees) for standard deviation of paired differences. Conclusions Skull X-RAYs provide accurate and reliable measurements for CI insertion depth. The Caldwell view alone may be sufficient for evaluations of insertion depth, and experience has a minor impact on the variability of estimates. |
| format | Article |
| id | doaj-art-df4feb642b544977ac542c27e7911c94 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-df4feb642b544977ac542c27e7911c942025-02-03T00:22:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162018-09-014711710.1186/s40463-018-0304-9Effectiveness of skull X-RAY to determine cochlear implant insertion depthVinay Fernandes0Yiqiao Wang1Robert Yeung2Sean Symons3Vincent Lin4Division of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of TorontoFaculty of Medicine, University of OttawaDivision of Radiology, Faculty of Medicine, University of TorontoDivision of Radiology, Faculty of Medicine, University of TorontoDivision of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of TorontoAbstract Background Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however its effectiveness has not been well established. Our primary objective was to assess the accuracy of post-op skull X-RAYs to determine insertion depth, compared to CT as the gold standard. Secondary objectives were to compare experience level of raters and different skull X-RAY views. Methods Thirteen patients with Advanced Bionic HiRes 90 K implants, and post-operative temporal bone CT scans were selected from the CI database at Sunnybrook Health Sciences Centre. Medical students, otology fellows, and CI surgeons evaluated insertion depths on post-op skull X-RAYs, while neuroradiologists evaluated CT scans. Descriptive statistics, regression analysis, and paired t-tests were used to compare the two types of imaging. Results X-RAYs and CTs provided an equivalent mean insertion depth of 337 degrees (p = 0.93), a mean difference of − 0.9 degrees and a standard deviation of paired differences of 43 degrees. Although means were similar across rater groups, CI surgeons (45 degrees) had the lowest standard deviation of paired differences. Comparing X-RAY views, Caldwell (29 degrees) had less variation than Towne (59 degrees) for standard deviation of paired differences. Conclusions Skull X-RAYs provide accurate and reliable measurements for CI insertion depth. The Caldwell view alone may be sufficient for evaluations of insertion depth, and experience has a minor impact on the variability of estimates.http://link.springer.com/article/10.1186/s40463-018-0304-9Cochlear implantInsertion depthCTX-RAY |
| spellingShingle | Vinay Fernandes Yiqiao Wang Robert Yeung Sean Symons Vincent Lin Effectiveness of skull X-RAY to determine cochlear implant insertion depth Journal of Otolaryngology - Head and Neck Surgery Cochlear implant Insertion depth CT X-RAY |
| title | Effectiveness of skull X-RAY to determine cochlear implant insertion depth |
| title_full | Effectiveness of skull X-RAY to determine cochlear implant insertion depth |
| title_fullStr | Effectiveness of skull X-RAY to determine cochlear implant insertion depth |
| title_full_unstemmed | Effectiveness of skull X-RAY to determine cochlear implant insertion depth |
| title_short | Effectiveness of skull X-RAY to determine cochlear implant insertion depth |
| title_sort | effectiveness of skull x ray to determine cochlear implant insertion depth |
| topic | Cochlear implant Insertion depth CT X-RAY |
| url | http://link.springer.com/article/10.1186/s40463-018-0304-9 |
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