MRI after Bonebridge implantation: a comparison of two implant generations
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OTOLOGY
MRI after Bonebridge implantation: a comparison of two implant generations Cristina Utrilla1 · Javier Gavilán2 · Pilar García‑Raya1 · Miryam Calvino2,3 · Luis Lassaletta2,3 Received: 6 May 2020 / Accepted: 15 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Analysis of head magnetic resonance images (MRI) of patients with active bone conduction implants (BCIs) is challenging. Currently, there are two generations of the transcutaneous Bonebridge system (BCI601 and BCI602), the main difference between them being the transducer design and thickness. The aim was to compare the effect of transducer placement and artifact reduction sequences on legibility of MRI scans. Methods Four Thiel-fixed human head specimens were used: BCI601 was implanted in sinodural and middle fossa placement, and BCI602 in middle fossa and retrosigmoid approach. Images were obtained with a Signa® 1.5T MR. A metal artifact reduction sequence known as MAVRIC (multiacquisition variable-resonance image combination) was used. Each specimen was scanned using standard axial T2 SE and compared with axial MAVRIC artifact reduction sequences. Results Qualitatively, limits of the artifact produced by the implant were better defined with MAVRIC than with standard T2 sequences. Assessment of contralateral internal auditory canal (IAC) was possible in all cases. Placement of the BCI602 in the middle fossa allowed the view of the ipsilateral IAC using MAVRIC sequence. Quantitatively, the artifact was reduced with MAVRIC sequence from 6.3 to 59.7%, depending on the position of implant and model; the middle fossa placement and the BCI602 being those generating shorter artifact radio. Conclusion Artifact optimized sequences as MAVRIC reduce the artifact caused by the Bonebridge system. The middle fossa approach allows a better visualization of IAC canal in the ipsilateral ear with both implant versions, but the effect is more prominent with the BCI602.
Introduction Bonebridge description Bone conduction hearing systems have become the standard of care for patients suffering from conductive or mixed hearing loss when middle ear surgery is not indicated, or conventional hearing aids are contraindicated or cannot be worn [1]. The transcutaneous Bonebridge® (BB) system (MED-EL, * Luis Lassaletta [email protected] 1
Department of Radiology, La Paz University Hospital, Madrid, Spain
2
Department of Otorhinolaryngology, La Paz University Hospital, IdiPAZ Research Institute, Paseo de la Castellana, 261, 28046 Madrid, Spain
3
Biomedical Research Networking Centre on Rare Diseases (CIBERER‑U761), Institute of Health Carlos III, Madrid, Spain
Innsbruck, Austria) is an active bone conduction implant, which differentiates it from passive bone conduction devices [2]. Indications for BB are similar to those of other bone conduction devices, and reports are favorable in terms of risk of complications, hearing outcomes, and patient satisfaction [3]. Surgery for implantation is straightforward, and th
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