A Systematic Review of Intraoperative X-Ray Images in Cochlear Implant.

Background and objective: In many medical centers, intraoperative imaging to determine the precise location of electrodes is part of the routine surgical program. However, the importance of this procedure has not yet been clearly established. This study aims to review the importance of intraoperative imaging in cochlear surgery and management measures.

Methods: Keyword searches were conducted in CINAHL, EMBASE, PubMed, and Cochrane databases from 2024. Abstracts and full texts of articles were reviewed by independent evaluators.

Results: The initial review identified 267 articles, of which 17 were eligible for inclusion in our study. There were no randomized controlled trials. Intraoperative imaging was performed in 917 cochlear implants. Nineteen implants were unsatisfactory (5.3%), and the management protocol was changed in 18 (94.7%). Sixty-nine cochlear implants underwent computed tomography (CT; 7 studies). CT was unsatisfactory in 2 implants, and the management was changed in both (1000%). Two studies evaluated fluoroscopy in patients undergoing cochlear implant.

Conclusion: Intraoperative imaging can be useful in determining electrode placement in cochlear implant surgery. This method is not yet considered routine, but it appears useful in cases where the surgeon is uncertain about electrode placement or in cases of abnormal cochlear anatomy.