cochlear implant
Cochleaimplantat
beidseits in der Computertomographie (5,5 mm, 10 mm MIP, 1.25 mm)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 15-year-old male patient, with normal postoperative finding after CI surgery. CBCT paracoronal image (left image) shows an electrode array located in the scala tympani (lower segment) of the cochlear duct (white arrow). BT – basal turn. MT – middle turn. AT – apical turn. CBCT paraaxial image (right image) shows the most basal electrode contact for this type of implant correctly located 3 mm below the round window
Cochlear
implant • Normal mastoid series with cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implants - bilateral - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implants - bilateral - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear
implant • Modified Stenvers view - Ganzer Fall bei Radiopaedia
Cochlear
implant • Modified Stenvers view - Ganzer Fall bei Radiopaedia
Cochlear
implant • Cochlear implant (illustration) - Ganzer Fall bei Radiopaedia
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 4-year-old male patient, with pain and insufficient hold of the speech processor after running into his brother. CT axial soft kernel image (left image) shows marked hematoma (arrows) in the skin at the frontal bone and temporal bone around the implanted magnet (hollow arrow). No intracranial bleeding. CT bone kernel axial image (right image) shows intact bone. The magnet is in the correct position
Pre- and
post-operative imaging of cochlear implants: a pictorial review. Postoperative evaluation of cochlear implant location using multiplanar mid-modiolar reconstructions. CBCT paracoronal reconstruction at the basal turn (left image) and paraaxial reconstruction through the modiolus (right image). Maximum intensity projections may be used to visualize the entire electrode array
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 70-year-old male patient, with normal postoperative finding after split electrode surgery due to far advanced otosclerosis. CBCT paracoronal image (left) shows basal electrode (BE) with the tip up to the first half of the basal turn (arrow). CBCT paraaxial maximum intensity projection image shows the additional apical electrode (AE) in the middle turn. C – cochlea. V – vestibulum
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 66-year-old female patient, with underinserted electrode. CBCT paraaxial maximum intensity projection image shows extracochlear location of electrode contacts 9 to 12
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 51-year-old male patient, with normal postoperative finding after retrograde electrode surgery due to cochlear fibrosis. CBCT axial image (left image) shows electrode entering at the middle turn (MT). CBCT paraaxial maximum intensity projection image (right image) shows the electrode running down the basal turn (BT). The two most distal electrode contacts are in the tympanic space and need to be deactivated
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 72-year-old male patient, with electrode lifting the basilar membrane. CBCT paracoronal image shows the electrode array located in a lateralized and elevated intermediate position between scala vestibuli (black arrow) and scala tympani (white arrow). BT – basal turn. MT – middle turn. AT – apical turn
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 70-year-old female patient, with an electrode placed in the scala vestibuli. CBCT paracoronal image shows an electrode array located in the scala vestibuli (upper segment) of the cochlear duct (black arrow). BT – basal turn. MT – middle turn. AT – apical turn
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 62-year-old male patient, with the scalar translocated electrode. CBCT axial images show translocation of the electrode array from scala tympani (white arrow) into scala vestibuli (black arrow). The electrode was inserted via cochleostomy
Pre- and
post-operative imaging of cochlear implants: a pictorial review. Comparison of postoperative HRCT and CBCT in a 53-year-old female patient. Axial (left images) and paracoronal (right images) images. HRCT images show more metal artifacts (arrows) and blooming artifacts than CBCT images. However, the scalar location and number of electrode contacts can be reliably documented in both modalities
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 11-year-old male patient, with overinserted electrode. CBCT paraaxial maximum intensity projection image shows the most basal electrode contact 7 mm from the round window (arrowhead)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. a A 75-year-old female patient, with electrode bending. CBCT paraaxial image shows electrode bending (arrows) at the basal turn. b A 70-year-old male patient with electrode pinching in far advanced otosclerosis. CBCT paraaxial image shows accordion-like pinching of the basal parts of the electrode array (white arrows). The tip of the electrode array sticks at the basal turn and does not turn around the modiolus (black arrow)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 66-year-old male patient, with tip fold-over. CBCT paraaxial maximum intensity projection image shows fold-over of the tip of the electrode in the cochlea (arrow)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 55-year-old female patient, with basal fold-over. CBCT paraaxial maximum intensity projection image shows fold-over of the basal part of the electrode within the cochlea (arrowhead)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 13-year-old female patient, with CHARGE syndrome and malposition of the electrode in the tympanic cavity (asterisk). CBCT axial image shows the apical part of the electrode array (arrow) not passing the angled entry of the round window into the basal turn (BT)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 20-year-old male patient, with incomplete partition type III and malposition of the electrode in the internal auditory canal. CBCT paraaxial maximum intensity projection image shows part of the electrode array in the basal turn (arrow), but the rest of the electrode forming a slope within the internal auditory canal (asterisk)
Pre- and
post-operative imaging of cochlear implants: a pictorial review. a A 86-year-old male patient, with immediate postoperative nausea. CBCT paracoronal maximum intensity projection image shows the malposition of the electrode in the superior semi-circular canal (SSCC). b A 20-year-old male patient with asymptomatic malposition of the electrode in the posterior semi-circular canal (PSCC) on CBCT paraaxial maximum intensity projection image
Pre- and
post-operative imaging of cochlear implants: a pictorial review. A 53-year-old male patient, with a complete malfunction of the CI and pain 3 months after CI surgery. CBCT paraaxial maximum intensity projection image shows initial overinsertion of the electrode array (a). The control scan shows back extrusion of the electrode array with migrated positions of the electrode tip (arrow) and basal electrode element (arrowhead) and straightened electrode array (black arrows) in the mastoidectomy cave (b)
Cochlear
implant • Cochlear implant - Ganzer Fall bei Radiopaedia
Cochlear implants (CI) are a surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard of hearing. Unlike conventional hearing aids, the cochlear implant does not amplify sound, but works by directly stimulating any functioning auditory nerves inside the cochlea with an electric field.
External components of the cochlear implant include a microphone, speech processor and a radiofrequency (RF) transducer or primary headpiece coil. A secondary coil is implanted beneath the scalp and inductively coupled to the primary headpiece coil.
The implant gives recipients additional auditory information, which may include sound discrimination fine enough to understand speech in quiet environments. Post-implantation rehabilitative therapy is often critical to ensuring successful outcomes.
Radiographic features
Plain radiograph
Post operative plain film radiography of the temporal bones are sufficient in a majority of patients. Plain radiography is the most helpful modality to assess for extrusion and superior in assessing the number of inserted electrodes. Typically a modified Stenvers view is performed, which has succeeded the original Stenvers view.
CT
Particularly useful when postoperative radiographs fail to demonstrate the location of the electrode array adequately or if postoperative infection is suspected .
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Cochleaimplantat: