Evaluating temporal bone column density for optimized bone conduction implant placement

Emile Talon; Franca Wagner; Stefan Weder; Lukas Anschuetz; Marco Caversaccio; Wilhelm Wimmer

doi:10.3389/fsurg.2023.1293616

Evaluating temporal bone column density for optimized bone conduction implant placement

Front Surg. 2023 Nov 30:10:1293616. doi: 10.3389/fsurg.2023.1293616. eCollection 2023.

Authors

Emile Talon^{1

2}, Franca Wagner³, Stefan Weder¹, Lukas Anschuetz¹, Marco Caversaccio^{1

2}, Wilhelm Wimmer^{1

4}

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.
² ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
³ Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.
⁴ Department of Otorhinolaryngology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Abstract

Introduction: An optimal placement of bone conduction implants can provide more efficient mechanical transmission to the cochlea if placed in regions with greater bone column density. The aim of this study was to test this hypothesis and to determine the clinical potential of preoperative bone column density assessment for optimal implant placement.

Methods: Five complete cadaver heads were scanned with quantitative computed tomography imaging to create topographic maps of bone density based on the column density index (CODI). Laser Doppler vibrometry was used to measure cochlear promontory acceleration under bone conduction stimulation in different locations on the temporal bone, using a bone-anchored hearing aid transducer at frequencies ranging from 355 Hz to 10 kHz.

Results: We found a statistically significant association between CODI levels and the accelerance of the cochlear promontory throughout the frequency spectrum, with an average increase of 0.6 dB per unit of CODI. The distance between the transducer and the cochlear promontory had no statistically significant effect on the overall spectrum.

Discussion: We highlight the importance of bone column density in relation to the mechanical transmission efficiency of bone conduction implants. It may be worthwhile to consider column density in preoperative planning in clinical practice.

Keywords: BAHA; bone column density; image-guided audiology; laser Doppler velocimetry; quantitative computed tomography; transmission efficiency.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.