Localisation by Impedance.

IF 1.3 4区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Audiology and Neuro-Otology Pub Date : 2025-08-26 DOI:10.1159/000548171

Alhassan Algazlan, Marzouqi Salamah, Dalal Alrushaydan, Hassan Yalcouy, Abdulrahman Hagr, Fida Almuhawas

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引用次数: 0

Abstract

Background: Accurate intracochlear positioning of electrode arrays is critical for optimizing auditory outcomes during cochlear implantation (CI). While radiographic imaging remains the standard for postoperative evaluation, transimpedance matrix (TIM) measurements have emerged as a promising intraoperative technique for real-time assessment of electrode placement, particularly with a slim modiolar electrode array.

Methods: This retrospective observational study included 15 patients (24 ears) who underwent CI using CI532® and CI632® electrode arrays. Intraoperative TIM data were obtained and compared with intraoperative and immediate postoperative radiographic imaging data to determine the accuracy and reliability of TIM in detecting electrode placement anomalies. The electrode positioning patterns were analyzed using TIM heatmaps, with a focus on the voltage gradient distribution and identification of the electrode tip fold-over (TFO).

Results: Of the 24 CIs, 23 (96%) exhibited a regular TIM voltage distribution consistent with proper modiolar placement. A single instance of TFO (4%) was identified intraoperatively using TIM and confirmed via radiographic imaging. The electrode was reinserted following intraoperative correction with TIM and imaging, subsequently confirming the optimal placement. In all remaining cases, the TIM findings were in concordance with radiological assessments.

Conclusion: TIM may be a reliable intraoperative monitoring tool for CI using slim modiolar CI532® and CI632® electrode arrays position during CI. Their ability to accurately detect deviations in electrode configuration, such as the TFO, affirms their potential to augment surgical precision, eliminate the need of intraoperative radiation exposure by providing real-time feedback, minimize postoperative imaging requirements, and enhance patient outcomes. Further prospective studies with larger cohorts are warranted to validate these preliminary findings and establish standardized protocols for clinical implementation.

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阻抗定位。

背景：在人工耳蜗植入（CI）过程中，耳蜗内电极阵列的准确定位对于优化听觉结果至关重要。虽然放射成像仍然是术后评估的标准，但跨阻抗矩阵（TIM）测量已经成为一种有前途的术中实时评估电极放置的技术，特别是与细长模摩尔电极阵列一起使用。方法：本回顾性观察研究纳入15例（24耳）采用CI532®和CI632®电极阵列行CI的患者。获取术中TIM数据，并与术中及术后即刻放射成像数据进行比较，以确定TIM检测电极放置异常的准确性和可靠性。利用TIM热图分析了电极定位模式，重点研究了电压梯度分布和尖端褶皱（TFO）的识别。结果：在24个ci中，23个（96%）表现出与适当的模摩尔放置一致的规则的TIM电压分布。术中使用TIM识别出一例TFO(4%)，并通过放射成像证实。术中使用TIM进行矫正并进行影像学检查，确认最佳放置位置后重新插入电极。其余病例的TIM检查结果与放射学评估一致。结论：采用Slim Modiolar CI532®和CI632®电极阵列定位，TIM可作为人工耳蜗植入术中可靠的CI监测工具。它们能够准确地检测电极结构的偏差，如TFO，这证实了它们提高手术精度的潜力，通过提供实时反馈消除术中辐射暴露的需要，最大限度地减少术后成像要求，并提高患者的预后。进一步的前瞻性研究需要更大的队列来验证这些初步发现，并为临床实施建立标准化的方案。

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 and Neuro-Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： ''Audiology and Neurotology'' provides a forum for the publication of the most-advanced and rigorous scientific research related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear. This journal seeks submission of cutting edge research opening up new and innovative fields of study that may improve our understanding and treatment of patients with disorders of the auditory and vestibular systems, their central connections and their perception in the central nervous system. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines.