Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav.

IF 2.1 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Stefano Concheri, Davide Brotto, Marzia Ariano, Antonio Daloiso, Valerio Maria Di Pasquale Fiasca, Flavia Sorrentino, Beatrice Coppadoro, Patrizia Trevisi, Elisabetta Zanoletti, Sebastiano Franchella
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引用次数: 0

Abstract

Objectives: The objectives were to present the real-time estimated values of cochlear implant (CI) electrode insertion speed (IS) during intraoperative sessions using the Cochlear Nucleus SmartNav System to assess whether this measure affected CI outcomes and to determine whether real-time feedback assists expert surgeons in achieving slow insertion.

Methods: The IS was measured in 52 consecutive patients (65 implanted ears) using the CI632 electrode. The IS values were analyzed in relation to procedure repetition over time, NRT ratio, and CI audiological outcomes.

Results: The average IS was 0.64 mm/s (SD = 0.24); minimum and maximum values were 0.23 and 1.24 mm/s, respectively. The IS significantly decreased with each array insertion by the operator (p = 0.006), and the mean decreased by 24% between the first and last third of procedures; however, this reduction fell within the error range of SmartNav for IS (+/-0.48 mm/s). No correlation was found between IS and the NRT ratio (p = 0.51), pure-tone audiometry (PTA) at CI activation (p = 0.506), and PTA (p = 0.94) or word recognition score (p = 0.231) at last evaluation.

Conclusions: The estimated IS reported by SmartNav did not result in a clinically significant reduction in insertion speed or an improvement in CI hearing outcomes. Real-time feedback of IS could potentially be used for training, but its effectiveness requires confirmation through additional studies and more accurate tools. Implementation of IS assessment in clinical practice will enable comparisons between measurement techniques and between manual and robot-assisted insertions. This will help define the optimal IS range to achieve better cochlear implant (CI) outcomes.

术中测量人工耳蜗植入手术的插入速度:使用科利耳 SmartNav 的初步经验。
目标:目的是在术中使用科利耳核磁 SmartNav 系统时,提供人工耳蜗植入(CI)电极插入速度(IS)的实时估计值,以评估该测量值是否会影响 CI 结果,并确定实时反馈是否有助于专家外科医生实现慢速插入:使用 CI632 电极连续测量了 52 名患者(65 只植入耳)的 IS 值。方法:使用 CI632 电极对连续 52 名患者(65 耳)进行了 IS 测量,分析了 IS 值与手术重复时间、NRT 比率和 CI 听力结果的关系:平均 IS 值为 0.64 mm/s(SD = 0.24);最小值和最大值分别为 0.23 mm/s 和 1.24 mm/s。操作员每次插入阵列时,IS 都会明显下降(p = 0.006),手术的前三分之一和后三分之一之间的平均值下降了 24%;不过,这一下降在 SmartNav 的 IS 误差范围内(+/-0.48 mm/s)。没有发现 IS 与 NRT 比率(p = 0.51)、CI 激活时的纯音测听(PTA)(p = 0.506)以及最后一次评估时的 PTA(p = 0.94)或单词识别分数(p = 0.231)之间存在相关性:结论:SmartNav 报告的 IS 估计值并未显著降低插入速度或改善 CI 听力结果。IS的实时反馈有可能用于培训,但其有效性还需要更多的研究和更精确的工具来证实。在临床实践中实施 IS 评估可对测量技术进行比较,也可对人工插入和机器人辅助插入进行比较。这将有助于确定最佳的 IS 范围,以获得更好的人工耳蜗植入 (CI) 效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Audiology Research
Audiology Research AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-
CiteScore
2.30
自引率
23.50%
发文量
56
审稿时长
11 weeks
期刊介绍: The mission of Audiology Research is to publish contemporary, ethical, clinically relevant scientific researches related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear that can be used by clinicians, scientists and specialists to improve understanding and treatment of patients with audiological and neurotological disorders.
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