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. 2013 Sep 3;18(1):30.
doi: 10.1186/2047-783X-18-30.

Visualisation of the Bonebridge by means of CT and CBCT

Christian Güldner  1 , Julia Heinrichs, Rainer Weiß, Annette Paula Zimmermann, Benjamin Dassinger, Siegfried Bien, Jochen Alfred Werner, Isabell Diogo
Affiliations

Visualisation of the Bonebridge by means of CT and CBCT

Christian Güldner et al. Eur J Med Res. .

Abstract

Background: With the Bonebridge, a new bone-anchored hearing aid has been available since March 2012. The objective of the study was to analyse the visualisation of the implant itself as well as its impact on the representation of the bony structures of the petrosal bone in CT, MRI and cone beam CT (CBCT).

Methods: The Bonebridge was implanted unilaterally in two completely prepared human heads. The radiological imaging by means of CBCT, 64-slice CT, 1.5-T and 3.0-T MRI was conducted both preoperatively and postoperatively. The images were subsequently evaluated from both the ENT medical and nd radiological perspectives.

Results: As anticipated, no visualisation of the implant or of the petrosal bones could be realised on MRI because of the interactive technology and the magnet artefact. In contrast, an excellent evaluability of the implant itself as well as of the surrounding neurovascular structures (sinus sigmoideus, skull base, middle ear, inner ear, inner auditory canal) was exhibited in both the CT and in the CBCT.

Conclusion: The Bonebridge can be excellently imaged with the radiological imaging technologies of CT and CBCT. In the process, CBCT shows discrete advantages in comparison with CT. No relevant restrictions in image quality in the evaluation of the bony structures of the petrosal bones could be seen.

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Figures

Figure 1
Figure 1
Preoperative CBCT (A and B) and intraoperative images (C and D). Preoperative radiological visualisation by CBCT of the site in the case of a well-pneumatised and not pre-operated mastoid (A) as well as a site with prior surgery in terms of a transcanalicular partial mastoidectomy (B). Presentation of the site after the drilling of the bed (C) and fixation of the implant (D).
Figure 2
Figure 2
Visualisation of the implant. Three-dimensional reconstruction of the implant from the raw data of the CBCT (A) and CT (B). Imaging of the implant details including the inner structure and fixing screws in CBCT (C and D).
Figure 3
Figure 3
Positional relation of the implant to the posterior cranial fossa. Visualisation of the implants in CBCT (A and C) and in CT (B and D) for both prepared skulls (A and B, head 1; C and D, head 2) in relation to the surrounding brain structures (*).
Figure 4
Figure 4
Positional relation of the implant to the sinus sigmoideus. Visualisation of the implants in CBCT (A and C) and in CT (B and D) for both prepared skulls (A and B, head 1; C and D, head 2) in relation to the sinus sigmoideus (*).
See this image and copyright information in PMC

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