基于阻抗的耳蜗植入电极追踪可可靠检测阵列成功插入

文献信息

中文摘要

引言： 耳蜗植入过程中连续阻抗测量已被假设可提供电极位于耳蜗内或外的可靠指示。因此，它们为外科医生提供了成功插入的有价值反馈机制。本研究旨在探讨阻抗是否可用于可靠检测耳蜗植入电极阵列的成功插入。
方法： 在一项前瞻性横断面单中心研究中，招募了2022年6月至2023年5月期间接受柔性侧壁阵列（MED-EL，奥地利因斯布鲁克）耳蜗植入的患者。获取电极阵列插入过程中的连续阻抗遥测，并与外科医生视觉和听力学反馈的基准真值进行比较。
结果： 共纳入34例患者（23名女性，11名男性；16只左耳，18只右耳），平均年龄52.8岁（标准差19.6岁）。本研究发现，将连续插入算法与基准真值进行比较，可靠性为88.9%。
结论： 连续阻抗测量在检测耳蜗植入电极阵列的电极触点插入方面显示出高可靠性。软件收集的数据适合在插入过程中即检测到错位。该方法是一种有前景的术中监测成功插入的方法，并提供了在耳蜗植入手术后护理中替代透视和放射成像的机会。

英文摘要

INTRODUCTION: Continuous impedance measurements during cochlear implantation have been hypothesized to provide a reliable indication if the electrode is inside or outside the cochlea. Therefore they provide a valuable feedback mechanism for successful insertion to the surgeon. This study aims to investigate whether impedances can be used to reliably detect successful insertion of the cochlear -implant electrode array.
METHODS: In a prospective cross-sectional single-center study patients undergoing cochlear implantation with flexible lateral wall arrays (MED-EL, Innsbruck, Austria) were recruited between June 2022 and May 2023. Continuous impedance telemetry during electrode array insertion was obtained and compared to the ground truth of visual and audiological feedback by the surgeon.
RESULTS: 34 patients (23 women, 11 men;, 16 left ears, 18 right ears) with a mean age of 52.8 years (SD 19.6 years) were included. The present study found a reliability of 88.9% comparing the algorithm of continuous insertion to the ground truth.
CONCLUSIONS: Continuous impedance measurements show a high reliability to detect the insertion of electrode contacts of a cochlear implant electrode array. The data collected by the software are suitable to detect misplacements already during insertion. This method is a promising approach to intraoperatively monitor successful insertion and offers the opportunity to replace fluoroscopy and radiological imaging in the aftercare of cochlear implant surgery.