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      Umfassender Literaturüberblick über die Anwendung der otologisch-chirurgischen Planungssoftware OTOPLAN® bei der Cochleaimplantation Translated title: Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN® for cochlear implantation. German version

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          Abstract

          Hintergrund

          Die Größe der menschlichen Cochlea, gemessen am Durchmesser der Basalwindung, schwankt zwischen 7 und 11 mm. Im Rahmen einer Hörrehabilitation durch ein Cochleaimplantat ist diese für die individuelle Zuordnung der Frequenzbänder und die Wahl der Elektrodenlänge von Bedeutung. OTOPLAN® (CAScination AG [Bern, Schweiz] in Kooperation mit MED-EL [Innsbruck, Österreich]) ist ein Softwaretool mit CE-Kennzeichnung für klinische Anwendungen in der Cochleaimplantat(CI)-Behandlung, welches die Vorplanung auf Grundlage der cochleären Größenparameter durchführt. Ziel dieser Literaturübersicht ist es, alle veröffentlichten Studien über die Anwendung von OTOPLAN® zu erfassen.

          Materialien und Methoden

          Die PRISMA-Richtlinien (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) wurden angewandt, um relevante Studien zu identifizieren, die zwischen Januar 2015 und Februar 2023 in der Suchmaschine PubMed veröffentlicht wurden (unter Verwendung der Suchbegriffe „otoplan“ [Titel/Abstract] OR „anatomy-based fitting“ [Titel/Abstract] OR „otological software tool“ [Titel/Abstract] OR „computed tomography-based software AND cochlear“ [Titel/Abstract]).

          Ergebnisse

          Bei der systematischen Durchsicht der Literatur wurden 32 Studien über den klinischen Einsatz von OTOPLAN® bei der CI-Behandlung gefunden. Die meisten Studien wurden von deutschen Arbeitsgruppen publiziert (7 von 32), gefolgt von Italien (5), Saudi-Arabien (4), USA (4) und Belgien (3). So stammten je 2 Studien aus Österreich und China, gefolgt von jeweils 1 Studie aus Frankreich, Indien, Norwegen, Südkorea und der Schweiz. In den meisten Studien (22) wurde OTOPLAN® zur Beurteilung der Cochleagröße verwendet, gefolgt von der Visualisierung der Elektrodenposition anhand postoperativer Bilder (5), der dreidimensionalen (3-D-)Segmentierung der Felsenbeinstrukturen (4), der Planung der Elektrodeneinführungstrajektorie (3), der Erstellung einer patientenspezifischen Frequenzbandzuordnung (3), der Planung eines sicheren Bohrpfads durch den Recessus facialis (3), und der Messung von Felsenbeinstrukturen (1).

          Schlussfolgerung

          OTOPLAN® ist bisher der einzige DICOM-Viewer mit CE-Kennzeichnung im CI-Bereich, der prä-, intra- und postoperative Bilder mit den genannten Anwendungen verarbeiten kann.

          Translated abstract

          Background

          The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®.

          Materials and methods

          The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms “otoplan” [title/abstract] OR “anatomy-based fitting” [title/abstract] OR “otological software tool” [title/abstract] OR “computed tomography-based software AND cochlear” [title/abstract].

          Results

          The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1).

          Conclusion

          To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.

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          Most cited references50

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

          David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
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            • Article: not found

            Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study

            Summary Background Although CT scans are very useful clinically, potential cancer risks exist from associated ionising radiation, in particular for children who are more radiosensitive than adults. We aimed to assess the excess risk of leukaemia and brain tumours after CT scans in a cohort of children and young adults. Methods In our retrospective cohort study, we included patients without previous cancer diagnoses who were first examined with CT in National Health Service (NHS) centres in England, Wales, or Scotland (Great Britain) between 1985 and 2002, when they were younger than 22 years of age. We obtained data for cancer incidence, mortality, and loss to follow-up from the NHS Central Registry from Jan 1, 1985, to Dec 31, 2008. We estimated absorbed brain and red bone marrow doses per CT scan in mGy and assessed excess incidence of leukaemia and brain tumours cancer with Poisson relative risk models. To avoid inclusion of CT scans related to cancer diagnosis, follow-up for leukaemia began 2 years after the first CT and for brain tumours 5 years after the first CT. Findings During follow-up, 74 of 178 604 patients were diagnosed with leukaemia and 135 of 176 587 patients were diagnosed with brain tumours. We noted a positive association between radiation dose from CT scans and leukaemia (excess relative risk [ERR] per mGy 0·036, 95% CI 0·005–0·120; p=0·0097) and brain tumours (0·023, 0·010–0·049; p<0·0001). Compared with patients who received a dose of less than 5 mGy, the relative risk of leukaemia for patients who received a cumulative dose of at least 30 mGy (mean dose 51·13 mGy) was 3·18 (95% CI 1·46–6·94) and the relative risk of brain cancer for patients who received a cumulative dose of 50–74 mGy (mean dose 60·42 mGy) was 2·82 (1·33–6·03). Interpretation Use of CT scans in children to deliver cumulative doses of about 50 mGy might almost triple the risk of leukaemia and doses of about 60 mGy might triple the risk of brain cancer. Because these cancers are relatively rare, the cumulative absolute risks are small: in the 10 years after the first scan for patients younger than 10 years, one excess case of leukaemia and one excess case of brain tumour per 10 000 head CT scans is estimated to occur. Nevertheless, although clinical benefits should outweigh the small absolute risks, radiation doses from CT scans ought to be kept as low as possible and alternative procedures, which do not involve ionising radiation, should be considered if appropriate. Funding US National Cancer Institute and UK Department of Health.
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              Frequency map for the human cochlear spiral ganglion: implications for cochlear implants.

              The goals of this study were to derive a frequency-position function for the human cochlear spiral ganglion (SG) to correlate represented frequency along the organ of Corti (OC) to location along the SG, to determine the range of individual variability, and to calculate an "average" frequency map (based on the trajectories of the dendrites of the SG cells). For both OC and SG frequency maps, a potentially important limitation is that accurate estimates of cochlear place frequency based upon the Greenwood function require knowledge of the total OC or SG length, which cannot be determined in most temporal bone and imaging studies. Therefore, an additional goal of this study was to evaluate a simple metric, basal coil diameter that might be utilized to estimate OC and SG length. Cadaver cochleae (n = 9) were fixed <24 h postmortem, stained with osmium tetroxide, microdissected, decalcified briefly, embedded in epoxy resin, and examined in surface preparations. In digital images, the OC and SG were measured, and the radial nerve fiber trajectories were traced to define a series of frequency-matched coordinates along the two structures. Images of the cochlear turns were reconstructed and measurements of basal turn diameter were made and correlated with OC and SG measurements. The data obtained provide a mathematical function for relating represented frequency along the OC to that of the SG. Results showed that whereas the distance along the OC that corresponds to a critical bandwidth is assumed to be constant throughout the cochlea, estimated critical band distance in the SG varies significantly along the spiral. Additional findings suggest that measurements of basal coil diameter in preoperative images may allow prediction of OC/SG length and estimation of the insertion depth required to reach specific angles of rotation and frequencies. Results also indicate that OC and SG percentage length expressed as a function of rotation angle from the round window is fairly constant across subjects. The implications of these findings for the design and surgical insertion of cochlear implants are discussed.

                Author and article information

                Contributors
                Mueller_F7@ukw.de
                Journal
                HNO
                HNO
                Hno
                Springer Medizin (Heidelberg )
                0017-6192
                1433-0458
                8 April 2024
                8 April 2024
                2024
                : 72
                : 10
                : 687-701
                Affiliations
                GRID grid.411760.5, ISNI 0000 0001 1378 7891, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, , Universitätsklinikum Würzburg, ; Josef-Schneider-Straße 11, 97080 Würzburg, Deutschland
                Article
                1461
                10.1007/s00106-024-01461-8
                11422278
                38587661
                7d650908-0838-4f20-b659-b71bc28eae1f
                © The Author(s) 2024

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                History
                : 28 November 2023
                Funding
                Funded by: Universitätsklinikum Würzburg (8913)
                Categories
                Originalien
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2024

                anatomiebasiertes fitting,computertomographie-basierte software ohr/cochlea,bildgebungsmodalitäten (mrt, computertomographie [flat-panel volume ct]),cochleäre länge,computersimulation,anatomy based fitting,computed tomography-based software cochlear,imaging modalities (mri, computer tomography [flat-panel volume ct]),cochlear duct length,computer simulation

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