{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:12:17Z","timestamp":1785251537163,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the role of intraoperative radiographs to confirm electrode position following pediatric cochlear implantation (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary care pediatric center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted, including all pediatric patients undergoing CI at UPMC Children's Hospital of Pittsburgh over a 13\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 326 patients undergoing 492 procedures. Across the cohort, there were 7 cases that required intraoperative electrode reinsertion due to malposition or presumed malposition. For 6 of the 7 cases, intraoperative X\u2010ray identified electrode malposition. Neural response telemetry (NRT) testing was also abnormal for 4 of these cases prior to reinsertion. Implantation of Cochlear's Slim Modiolar electrode was associated with an abnormal perioperative X\u2010ray (odds ratio [OR]: 9.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) and increased change in management (OR: 9.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) compared to Cochlear's Contour Advance (CA). Incidence of abnormal X\u2010rays was 1.24% overall, 4% in the Slim Modiolar group, and 0.3% in the CA group. The Slim Modiolar electrode accounted for 4 of 7 cases requiring reinsertion, and in all 4 of these cases, electrode fold\u2010over was identified on the X\u2010ray. NRT was normal in 1 of these 4 cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of Cochlear's Slim Modiolar electrode was associated with a significantly increased risk of abnormal intraoperative X\u2010ray compared to the CA electrode. Given the risk of fold\u2010over with routine insertion and normal electrical testing using the Slim Modiolar electrode, we recommend routine use of intraoperative skull X\u2010ray to confirm electrode position.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.346","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T04:45:44Z","timestamp":1681361144000},"page":"1282-1289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Utility of Intraoperative Radiographs in Pediatric Cochlear Implant Surgery"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4563-0933","authenticated-orcid":false,"given":"Emily","family":"Savoca","sequence":"first","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Ear, Nose &amp; Throat Surgeons of Western New England  Springfield Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Smith","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-9198","authenticated-orcid":false,"given":"Amber D.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Kitsko","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chi","sequence":"additional","affiliation":[{"name":"UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.19088"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.05.018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05708-x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215118001871"},{"issue":"02","key":"e_1_2_8_6_1","article-title":"Tip fold\u2010over with the Slim Modiolar electrode (CI 532), a retrospective case series","volume":"97","author":"Lang C","year":"2018","journal-title":"Laryngo\u2010Rhino\u2010Otologie"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001652"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001915"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joto.2019.01.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820907336"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29224"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2017.05.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115001966"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/app11094144"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182423175"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23665"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31818d1cd2"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/14670100.2017.1403146"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003290"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002875"},{"key":"e_1_2_8_21_1","unstructured":"Biotech Dispatch. Cochlear announces FDA approval of four new products. 2020. Accessed October 10 2022.https:\/\/biotechdispatch.com.au\/news\/cochlear-announces-fda-approval-of-four-new-products"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:01:30Z","timestamp":1760968890000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1002\/ohn.346"],"URL":"https:\/\/doi.org\/10.1002\/ohn.346","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]},"assertion":[{"value":"2022-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}