Dynamic Intraoperative Interpretation of TIM Heatmaps: Fluoroscopic Correlation of Skip and Central Heat TIM Patterns in Cochlear Malformation

To describe intraoperative fluoroscopic and transimpedance matrix (TIM) findings during cochlear implantation in a patient with bilateral cochlear malformations, highlighting the dynamic relationship between electrode position and evolving TIM heatmap patterns.

In cochlear implantation for patients with cochlear malformations, combining intraoperative TIM heatmap monitoring with fluoroscopy can help identify atypical electrode placement patterns (skip and central heat); surgeons performing implantation in malformed cochleas should be familiar with these TIM signatures.

Characterising abnormal intraoperative TIM patterns in cochlear malformations expands the interpretive framework for real-time electrode placement guidance, potentially improving surgical outcomes in anatomically complex cases.

1. 01Single-patient case study of cochlear implantation in bilateral cochlear malformations.
2. 02Two distinct TIM heatmap patterns — 'skip' and 'central heat' — were identified and correlated with fluoroscopic imaging.
3. 03TIM heatmap interpretation was used as a real-time intraoperative guide alongside fluoroscopy.
4. 04Findings extend TIM pattern classification beyond previously described presentations in normal cochlear anatomy.
5. 05Results are preliminary (N=1) and require validation in larger case series.

PMID

42153766

DOI

10.1097/MAO.0000000000004944.

Journal

Otology & Neurotology

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single patient with bilateral cochlear malformations undergoing cochlear implantation

Intervention

Intraoperative TIM heatmap monitoring combined with fluoroscopy during cochlear implantation