Angular Insertion Depth in Inner Ear Malformations, Relationship to Cochlear Size, and Implications for Electrode Selection.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Author(s): Tellioğlu B;Tellioğlu B; Sennaroğlu L
  • Source:
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2025 Jan 01; Vol. 46 (1), pp. e9-e16. Date of Electronic Publication: 2024 Oct 28.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100961504 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-4505 (Electronic) Linking ISSN: 15317129 NLM ISO Abbreviation: Otol Neurotol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2001-
    • Subject Terms:
    • Abstract:
      Objective: The objectives were to determine the interrater agreement of the Skull AP X-ray in measuring angular insertion depth (AID), to provide descriptive information about the insertion depths of different electrodes used in inner ear malformations (IEMs), to investigate the effect of cochlear size and electrode length on AID, and to guide clinicians in electrode selection in IEMs.
      Study Design: Retrospective case review.
      Setting: Tertiary referral center.
      Patients: A total of 198 IEMs (n = 169 patients) and 60 cochleae with normal anatomy (n = 60 patients) were selected from patients with severe mixed or sensorineural hearing loss who presented to our clinic and underwent cochlear implantation (CI) between January 2010 and December 2022.
      Interventions: Three neurotologists independently measured AID on Skull AP X-rays. Basal turn length of the cochlea was measured in axial and coronal oblique reformatted sections on HRCT images.
      Main Outcome Measures: Interrater reliability (ICC) of the AID measurements on Skull AP X-ray, determining the impact of cochlea size and electrode length on AID measurements.
      Results: The interrater reliability (ICC) test showed a high level of consistency in measuring AID in the Skull AP X-ray ( R = 0.906, p < 0.001). In the control group, a negative correlation was observed between the AID and the basal turn length of the cochlea, while a positive correlation was found between electrode length and AID ( R = 0.947, p < 0.001).
      Conclusions: The Skull AP X-ray appears to be a dependable tool for measuring AID. In cases of IEMs, it is important to select an electrode of appropriate length, considering the dimensions of the cochlea.
      Competing Interests: Conflict of interest: The authors have no relevant financial or nonfinancial interests to disclose.
      (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Otology & Neurotology, Inc.)
    • References:
      Sennaroğlu L, Bajin MD. Classification and current management of inner ear malformations. Balkan Med J 2017;34:397–411.
      Mangabeira-Albernaz PL. The Mondini dysplasia—from early diagnosis to cochlear implant. Acta Otolaryngol 1983;95(5–6):627–31.
      Holden LK, Finley CC, Firszt JB, et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear 2013;34:342–60.
      Schurzig D, Timm ME, Batsoulis C, et al. Analysis of different approaches for clinical cochlear coverage evaluation after cochlear implantation. Otol Neurotol 2018;39:e642–50.
      Verbist BM, Skinner MW, Cohen LT, et al. Consensus panel on a cochlear coordinate system applicable in histologic, physiologic, and radiologic studies of the human cochlea. Otol Neurotol 2010;31:722–30.
      Sokolov M, Zavdy O, Raveh E, et al. Assessment of angular insertion-depth of bilateral cochlear implants using plain x-ray scans. Otol Neurotol 2020;41:1363–8.
      van der Jagt MA, Briaire JJ, Verbist BM, et al. Comparison of the HiFocus mid-scala and HiFocus 1J electrode array: angular insertion depths and speech perception outcomes. Audiol Neurootol 2016;21:316–25.
      Doubi A, Almuhawas F, Alzhrani F, et al. The effect of cochlear coverage on auditory and speech performance in cochlear implant patients. Otol Neurotol 2019;40:602–7.
      Hodges AV, Villasuso E, Balkany T, et al. Hearing results with deep insertion of cochlear implant electrodes. Otol Neurotol 1999;20:53–5.
      Heutink F, Verbist BM, van der Woude WJ, et al. Factors influencing speech perception in adults with a cochlear implant. Ear Hear 2021;42:949–60.
      O’Connell BP, Cakir A, Hunter JB, et al. Electrode location and angular insertion depth are predictors of audiologic outcomes in cochlear implantation. Otol Neurotol 2016;37:1016–23.
      O’Connell BP, Hunter JB, Gifford RH, et al. Electrode location and audiologic performance after cochlear implantation: a comparative study between nucleus CI422 and CI512 electrode arrays. Otol Neurotol 2016;37:1032–5.
      Hilly O, Smith L, Hwang E, et al. Depth of cochlear implant array within the cochlea and performance outcome. Ann Otol Rhinol Laryngol 2016;125:886–92.
      Canfarotta MW, Dillon MT, Brown KD, et al. Insertion depth and cochlear implant speech recognition outcomes: a comparative study of 28-and 31.5-mm lateral wall arrays. Otol Neurotol 2022;43:183–9.
      Franke-Trieger A, Mürbe D. Estimation of insertion depth angle based on cochlea diameter and linear insertion depth: a prediction tool for the CI422. Eur Arch Otorhinolaryngol 2015;272:3193–9.
      Escudé B, James C, Deguine O, et al. The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiology and Neurotology 2006;11(Suppl. 1):27–33.
      Sennaroglu L. Classification of Inner Ear Malformations, in Inner Ear Malformations . Springer; 2022:1–17.
      Pamuk G, Pamuk AE, Akgöz A, et al. Radiological measurement of cochlear dimensions in cochlear hypoplasia and its effect on cochlear implant selection. J Laryngol Otol 2021;135:501–7.
      Dhanasingh AE, We+iss NM, Erhard V, et al. A novel three-step process for the identification of inner ear malformation types. Laryngoscope Investigative Otolaryngology 2022;7:2020–8.
      Marsh MA, Xu J, Blamey PJ, et al. Radiologic evaluation of multichannel intracochlear implant insertion depth. Otol Neurotol 1993;14:386–91.
      Erixon E, Rask-Andersen H. How to predict cochlear length before cochlear implantation surgery. Acta Otolaryngol 2013;133:1258–65.
      Meng J, Li S, Zhang F, et al. Cochlear size and shape variability and implications in cochlear implantation surgery. Otol Neurotol 2016;37:1307–13.
      Avci E, Nauwelaers T, Lenarz T, et al. Variations in microanatomy of the human cochlea. J Comp Neurol 2014;522:3245–61.
      Hong R, Du Q, Pan Y. New imaging findings of incomplete partition type III inner ear malformation and literature review. Am J Neuroradiol 2020;41:1076–80.
      Parlak S, Gumeler E, Sennaroglu L, et al. X-linked deafness/incomplete partition type 3: radiological evaluation of temporal bone and intracranial findings. Diagn Interv Radiol 2022;28:50–7.
      Noble AR, Christianson E, Norton SJ, et al. Reliability of measuring insertion depth in cochlear implanted infants and children using cochlear view radiography. Otolaryngology–Head and Neck Surgery 2020;163:822–8.
      Sennaroglu L, Ozbal Batuk M. Incomplete Partition Type I, in Inner Ear Malformations: Classification, Evaluation and Treatment . Springer; 2022:241–56.
      Ozbal Batuk M., Sennaroglu L. Incomplete Partition Type II, in Inner Ear Malformations: Classification, Evaluation and Treatment. 2022, Springer. p. 257–270.
    • Publication Date:
      Date Created: 20241030 Date Completed: 20241212 Latest Revision: 20241212
    • Publication Date:
      20241213
    • Accession Number:
      10.1097/MAO.0000000000004357
    • Accession Number:
      39473309