How reliable is artificial intelligence in the diagnosis of cholesteatoma on CT images?

Purpose: This study analysed the main artificial intelligence (AI) models for the diagnosis of cholesteatoma on computed tomography (CT), evaluating their performance and comparing them with each other. The increasing application of AI in radiology requires a systematic comparison of available methodologies.

Methods: A systematic literature review was conducted, selecting relevant articles from the main databases.

Local anesthesia vs. general anesthesia in cochlear implant surgery: Impact on surgical duration, postoperative recovery, costs and clinical insights. An extensive meta-analysis.

Introduction: recent studies have shown that around 30 % of men and 20 % of women at the age of 70 have a hearing loss, rates that rise to 55 % and 45 % respectively at the age of 80. Treatment options include hearing aids and cochlear implants. Cochlear implant surgery under local anesthesia (L.

Correlation of Scalar Cochlear Volume and Hearing Preservation in Cochlear Implant Recipients with Residual Hearing.

Objective: Preservation of residual hearing is one of the main goals in cochlear implantation. There are many factors that can influence hearing preservation after cochlear implantation. The purpose of the present study was to develop an algorithm for validated preoperative cochlear volume analysis and to elucidate the role of cochlear volume in preservation of residual hearing preservation after atraumatic cochlear implantation.

The Dependency of Cochlear Lateral Wall Measurements on Observer and Imaging Type.

Hypothesis: Assessment techniques for the cochlear spatial lateral wall are associated with inter-rater variability, but derived clinical recommendations nonetheless offer value for individualized electrode selection.

Background: Anatomical variations influence the location of cochlear implant electrodes inside the cochlea. Preoperative planning allows individualization of the electrode based on characterization of the bony lateral wall.

Cochlear coverage with lateral wall cochlear implant electrode arrays affects post-operative speech recognition.

Objectives: The goal was to investigate the relationship between the insertion angle/cochlear coverage of cochlear implant electrode arrays and post-operative speech recognition scores in a large cohort of patients implanted with lateral wall electrode arrays.

Methods: Pre- and post-operative cone beam computed tomography scans of 154 ears implanted with lateral wall electrode arrays were evaluated. Traces of lateral wall and electrode arrays were combined into a virtual reconstruction of the implanted cochlea.

Estimating vibration artifacts in preclinical experimental assessment of actuator efficiency in bone-conduction hearing devices.

Objectives: Test feasibility of a means to distinguish artifact from relevant signal in an experimental method for pre-clinical assessment of bone conduction (BC) stimulation efficiency based on measurement of intracochlear pressure (ICP).

Methods: Experiments were performed on fresh-frozen human temporal bones and cadaver heads. In a first step, fiber optic pressure sensors inserted into the cochlea through cochleostomies were intentionally vibrated to generate relative motion versus the stationary specimen, and the resulting ICP artifact recorded, before and after attaching the sensor fiber to the bone with glue.

Virtual cochlear implantation for personalized rehabilitation of profound hearing loss.

In cochlear implantation, current preoperative planning procedures allow for estimating how far a specific implant will reach into the inner ear of the patient, which is important to optimize hearing preservation and speech perception outcomes. Here we report on the development of a methodology that goes beyond current planning approaches: the proposed model does not only estimate specific outcome parameters but allows for entire, three-dimensional virtual implantations of patient-specific cochlear anatomies with different types of electrode arrays. The model was trained based on imaging datasets of 186 human cochleae, which contained 171 clinical computer tomographies (CTs) of actual cochlear implant patients as well as 15 high-resolution micro-CTs of cadaver cochleae to also reconstruct the refined intracochlear structures not visible in clinical imaging.

Auditory rehabilitation after temporal bone fracture with cochlear implants - a case control study.

Objectives: Temporal bone fracture can cause posttraumatic deafness. Sequelae like ossification or obliteration of the cochlea can impact the outcome of cochlear implantation. This study highlights the effect of localisation of the fracture to morphologic, electric and functional criteria.

Cochlear Implantation in Obliterated Cochlea: A Retrospective Analysis and Comparison between the IES Stiff Custom-Made Device and the Split-Array and Regular Electrodes.

Anatomical malformations, obliterations of the cochlea, or re-implantations pose particular challenges in cochlear implantation. Treatment methods rely on radiological and intraoperative findings and include incomplete insertion, the implantation of a double array, and radical cochleostomy. In addition, a stiff electrode array, e.

Ex Vivo Evaluation of a Minimally Invasive Approach for Cochlear Implant Surgery.

Objectives: Drilling a minimally invasive access to the inner ear is a demanding task in which a computer-assisted surgical system can support the surgeon. Herein, we describe the design of a new micro-stereotactic targeting system dedicated to cochlear implant (CI) surgery and its experimental evaluation in an ex vivo study.

Methods: The proposed system consists of a reusable, bone-anchored reference frame, and a patient-specific drilling jig on top of it.

On the Accuracy of Clinical Insertion Angle Predictions With a Surgical Planning Platform for Cochlear Implantation.

Hypothesis: Various studies over the last few decades have shown that the cochlea is not a uniform structure, but that its size and shape may vary quite substantially in between subjects. The surgical planning platform enables the user to quickly approximate the size of a cochlea within clinical imaging data by measuring the basal cochlear diameters A and B. It also allows for contact specific insertion angle predictions for MED-EL cochlear implant electrode arrays based on this individual anatomy approximation.

Performance Evaluation of Coupling Variants for an Active Middle Ear Implant Actuator: Output, Conductive Losses, and Stability of Coupling With Ambient Pressure Changes.

Introduction: This study aims to investigate the performance of an active middle ear implant actuator for various coupling configurations. Actuator output and conductive losses were measured, and the stability of coupling was evaluated by challenging the link between actuator and ossicles through pressure events in magnitudes that occur in daily life.

Methods: Actuator coupling efficiency and the occurrence of conductive losses were measured in 10 temporal bones through laser Doppler vibrometry on the stapes footplate for various coupling types (incus short process with and without laser hole, incus long process, stapes head).

Gene networks and transcriptional regulators associated with liver cancer development and progression.

Background: Treatment options for hepatocellular carcinoma (HCC) are limited, and overall survival is poor. Despite the high frequency of this malignoma, its basic disease mechanisms are poorly understood. Therefore, the aim of this study was to use different methodological approaches and combine the results to improve our knowledge on the development and progression of HCC.

The Use of Clinically Measurable Cochlear Parameters in Cochlear Implant Surgery as Indicators for Size, Shape, and Orientation of the Scala Tympani.

Objectives: (1) To assess variations of the human intracochlear anatomy and quantify factors which might be relevant for cochlear implantation (CI) regarding surgical technique and electrode design. (2) Search for correlations of these factors with clinically assessable measurements.

Design: Human temporal bone study with micro computed tomography (μCT) data and analysis of intracochlear geometrical variations: μCT data of 15 fresh human temporal bones was generated, and the intracochlear lumina scala tympani (ST) and scala vestibuli were manually segmented using custom software specifically designed for accurate cochlear segmentation.

A cochlear scaling model for accurate anatomy evaluation and frequency allocation in cochlear implantation.

The human cochlea has a highly individual microanatomy. Cochlear implantation therefore requires an evaluation of the individual cochlear anatomy to reduce surgical risk of implantation trauma. However, in-vivo cochlear imaging is limited in resolution.

On the Intracochlear Location of Straight Electrode Arrays After Cochlear Implantation: How Lateral Are Lateral Wall Electrodes?

Objective: Cochlear implants are the gold standard for patients with severe sensorineural hearing loss. A focused electrical stimulation of individual spiral ganglion neurons has not been achieved yet because the scala tympani is a fluid-filled compartment and does not offer a matrix for neuritic outgrowth. Coating of the electrode contacts with swelling hydrogels could fill that gap between the electrode array and the medial wall of the cochlea.

First results of electrode reimplantation and its hypothetical dependence from artificial brain maturation.

Background: After introducing the first Cochlear Implants also in children theses are grown with electrical intracochlear stimulation and subsequent auditory cortical development. Over the meantime the positioning of the electrode was changed orientated on the development of electrode design, ability to insert atraumatic and on the widening of the indications towards highfrequency deafness.

Methods: In this pilot study we analysed five prelingually deafened patients implanted as child in the late 90's and had a reimplantation 2016 or later.

Tracheal Transection-A Novel Airway Management.

 Traumatic injury of the trachea is rare, especially complete transection. Its operative revision requires an interdisciplinary approach.  We hereby present a rare case of complete transection of the trachea by accident.

Intratympanic application of triamcinolone in sudden hearing loss-radiologic anatomy in cone beam CT and its' correlation to clinical outcome.

Purpose: To evaluate temporal bone cone-beam CT in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) being treated with primary and secondary intratympanic (IT) triamcinolone and to possibly correlate these results to the clinical outcome.

Methods: Retrospective analysis of patients treated with IT triamcinolone for ISSNHL at our department in 2018. Pre- and post-therapeutic audiologic examinations included four-tone average (FTA) at 0.

Individual Hearing Preservation Cochlear Implantation Using the Concept of Partial Insertion.

Objective: Aim of this study was to evaluate the method of partial insertion of flexible lateral wall electrodes in patients with residual hearing and potential electric-acoustic stimulation (EAS) users.

Patients And Intervention: N = 6 patients with a high-frequency hearing loss were treated with a partial insertion using atraumatic lateral wall electrodes. In three cases, a electrode of 24 mm length was inserted with the aim to achieve a 16 mm insertion depth and in three cases a electrode of 28 mm length to achieve a 20 mm insertion depth.

A Novel Method for Clinical Cochlear Duct Length Estimation toward Patient-Specific Cochlear Implant Selection.

Objective: In the field of cochlear implantation, the current trend toward patient-specific electrode selection and the achievement of optimal audiologic outcomes has resulted in implant manufacturers developing a large portfolio of electrodes. The aim of this study was to bridge the gap between the known variability of cochlea length and this electrode portfolio.

Design: Retrospective analysis on cochlear length and shape in micro-computed tomography and cone beam computed tomography data.