Detection of Tip Fold‐Over of the Slim Modiolar Electrode Using Intraoperative Mobile Cone‐Beam Computed Tomography

Abstract

AbstractObjectiveThis study aimed to evaluate the importance of mobile cone‐beam computed tomography in detecting tip fold‐over of a slim modiolar electrode within the cochlea during surgery.Study DesignRetrospective case review.SettingTertiary medical center.MethodsFrom January 2020 to June 2022, 33 ears of 30 patients with normal cochlear morphology underwent cochlear implantation with slim modiolar electrodes and intraoperative mobile cone‐beam computed tomography imaging. Furthermore, we retrospectively reviewed the medical records and images.ResultsThe tip fold‐over of the electrodes was detected using mobile cone‐beam computed tomography in 3 out of 33 ears (9.1%). We could not identify the tip fold‐over by scouting plain X‐ray images in 2 out of 3 cases before taking the cone‐beam computed tomography images. Electrode removal and reinsertion were performed before wound closure and the successful reinsertion was confirmed by mobile cone‐beam computed tomography. The folded electrode tips were located at 238.8°, 152°, and 185.8°.ConclusionIntraoperative mobile cone‐beam computed tomography is useful in detecting the tip fold‐over of the slim modiolar electrodes during surgery. Therefore, it was possible to reinsert the electrodes in all cases before closing the wound, eliminating the need for revision surgeries. Moreover, the analysis of mobile cone‐beam computed tomography images may help to elucidate the mechanisms of electrode tip fold‐over.