Confirmation of electrode placement during cochlear implantation has become a routine standard of care. The current gold standard solution of intraoperative imaging (e.g. X-ray or Fluoroscopy) can add time and costs to the procedure and exposes the patient and staff to radiation. The quality of imaging can also vary depending on the experience of the technician and is open to potential misinterpretation. Nucleus SmartNav, utilizing a Trans-Impedance Matrix via the Placement Check algorithm, can offer a faster alternative saving time and costs while providing patient benefit, providing an accurate alterative to the current gold standard.
In this article by Viral Tejani et al. at University Hospitals Cleveland (UH), a Sensitivity and Cost Analysis was performed comparing Nucleus SmartNav, with other alternative measurements like X-Ray, manual Trans-Impedance Matrix, and spread of excitation. UH found that SmartNav reduces the need for intraoperative imaging/radiation exposure and improves economics of cochlear implant operations without negatively affecting patient care. There is far greater variance in the time it takes to complete an x-ray than electrophysiologic testing, which significantly impacts OR efficiency.
Key Highlights of Tejani et al:
- Use of SmartNav is saving University Hospitals Cleveland $986 per case compared to X-ray
- Placement Check’s accuracy showed 100% Specificity and 100% Sensitivity across 113 ears
- One SmartNav system paid for itself after 4.56 cases
- Given the very low incidence of tip fold over, a multi-center study will help reinforce the accuracy and sensitivity measurements on a large scale, which is currently submitted for peer-review and publication
In summary, this study showed that SmartNav can provide a cost-effective, accurate alternative to intraoperative imaging, saving the practice time and costs. These measures provide the surgeon with valuable intraoperative diagnostics for informed decision-making while reducing anesthesia and radiation exposure. Metrics captured can also be easily accessed by audiology to use during activation, bringing value to everyone involved in a cochlear implant surgery.
Access to full article here: Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers.
For more information or to demo the Nucleus SmartNav System, please contact your local Cochlear Representative today.