Utility of Intraoperative Radiographs in Pediatric Cochlear Implant Surgery

人工耳蜗植入 医学 射线照相术 植入 听力学 放射科 外科
作者
Emily L. Savoca,Brandon Smith,Amber D. Shaffer,Dennis J. Kitsko,David Chi
出处
期刊:Otolaryngology-Head and Neck Surgery [Wiley]
卷期号:169 (5): 1282-1289 被引量:1
标识
DOI:10.1002/ohn.346
摘要

To evaluate the role of intraoperative radiographs to confirm electrode position following pediatric cochlear implantation (CI).Retrospective chart review.Single tertiary care pediatric center.A retrospective chart review was conducted, including all pediatric patients undergoing CI at UPMC Children's Hospital of Pittsburgh over a 13-year period.We identified 326 patients undergoing 492 procedures. Across the cohort, there were 7 cases that required intraoperative electrode reinsertion due to malposition or presumed malposition. For 6 of the 7 cases, intraoperative X-ray identified electrode malposition. Neural response telemetry (NRT) testing was also abnormal for 4 of these cases prior to reinsertion. Implantation of Cochlear's Slim Modiolar electrode was associated with an abnormal perioperative X-ray (odds ratio [OR]: 9.2, p = 0.03) and increased change in management (OR: 9.2, p = 0.03) compared to Cochlear's Contour Advance (CA). Incidence of abnormal X-rays was 1.24% overall, 4% in the Slim Modiolar group, and 0.3% in the CA group. The Slim Modiolar electrode accounted for 4 of 7 cases requiring reinsertion, and in all 4 of these cases, electrode fold-over was identified on the X-ray. NRT was normal in 1 of these 4 cases.The use of Cochlear's Slim Modiolar electrode was associated with a significantly increased risk of abnormal intraoperative X-ray compared to the CA electrode. Given the risk of fold-over with routine insertion and normal electrical testing using the Slim Modiolar electrode, we recommend routine use of intraoperative skull X-ray to confirm electrode position.
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