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Objective: The development of presentation-free teaching formats for practical exercises is a particular challenge. The objective of the presented project was the implementation of the practical course in otorhinolaryngology for learning examination techniques through digital distance learning.Methods: Disposable instruments for a comprehensive otorhinolaryngologic examination were purchased and made available to the students. The necessary light sources were everyday sports headlamps or flashlight constructions. The theoretical basics were taught using the learning platform CaseTrain, including photographic, audio and video material. Corresponding success controls in the sense of a digital short test were integrated here. In addition, video tutorials were used to present the examinations to be imitated in detail. In order to increase motivation, a creative photo competition was also announced, in which the practical tasks that were finally carried out independently were checked.Results: All students of the semester received a set of instruments for independent practical training. The entrance exam was passed by all students, and at least one photo was received from all students, many of which were particularly creative in the competition.Conclusion: The presented concept is a possibility to convert practical teaching formats into a digital presence-free concept. It included the teaching and testing of basic knowledge, instructions for practical exercises, the independent performance of subject-specific examination techniques and an increase in motivation and simultaneous control through gamification. We consider this teaching principle to be an attractive option for future “Flipped Classroom” concepts with a gradual resumption of face-to-face teaching.

Background: Correct individual tonotopic frequency stimulation of the cochlea plays an important role in the further development of anatomy-based cochlear implantation. In this context, frequency-specific fitting of the basal electrode contact with a normal insertion depth can be difficult since it is often placed in a frequency range higher than 10 kHz, and current audio processors only stimulate for frequencies up to 8.5 kHz due to microphone characteristics. This results in a mismatch of the high frequencies. Therefore, this study represents a proof of concept for a tonotopic correct insertion and aims to develop an algorithm for a placement of the basal electrode below 8.5 kHz in an experimental setting. Methods: Pre- and postoperative flat-panel volume CT scans with secondary reconstructions were performed on 10 human temporal bone specimens. The desired frequency location for the most basal electrode contact was set at 8.25 kHz. The distance from the round window to the position where the basal electrode contact was intended to be located was calculated preoperatively using 3D-curved multiplanar reconstruction and a newly developed mathematical approach. A specially designed cochlear implant electrode array with customized markers imprinted on the silicone of the electrode array was inserted in all specimens based on the individually calculated insertion depths. All postoperative measurements were additionally validated using otological planning software. Results: Positioning of the basal electrode contact was reached with only a small mean deviation of 37 ± 399 Hz and 0.06 ± 0.37 mm from the planned frequency of 8.25 kHz. The mean rotation angle up to the basal electrode contact was 51 ± 5°. In addition, the inserted electrode array adequately covered the apical regions of the cochleae. Conclusion: Using this algorithm, it was possible to position the basal electrode array contact in an area of the cochlea that could be correctly stimulated by the existing speech processors in the context of tonotopic correct fitting. Plain Language Summary: Tonotopic-matched stimulation of the cochlea is important in the context of anatomy-based cochlear implantation. The basal cochlear implant electrode contact is often placed in a frequency range higher than 10 kHz – when a normal insertion depth is reached – and can therefore be difficult to fit since current audio processors only stimulate for frequencies up to 8.5 kHz. This leads to a mismatch of high frequencies. This study represents a proof of concept for a tonotopic correct insertion and aims to develop an algorithm for a placement of the basal electrode below 8.5 kHz in an experimental setting. Therefore, pre- and postoperative CT scans were performed on 10 human temporal bone specimens. Tonotopic information about the aimed position of basal electrode contact was extracted from the imaging dataset by using 3D-curved multiplanar reconstruction and a newly developed mathematical approach. A specially designed cochlear implant electrode array was inserted in all specimens based on the individually calculated insertion depths. Positioning of the basal electrode contact was reached with only a small mean deviation of 37 ± 399 Hz and 0.06 ± 0.37 mm from the planned frequency of 8.25 kHz. In addition, the inserted electrode array adequately covered the apical regions of the cochleae. Using this algorithm, it was possible to position the basal electrode array contact in an area of the cochlea that can be correctly stimulated by the existing speech processors in the context of tonotopic correct fitting. [ABSTRACT FROM AUTHOR]

Background and Purpose: Anatomically adapted cochlear implantation and efficient postoperative cochlear implant-fitting strategies benefit from reliable and highly detailed imaging techniques. Since image quality in CT is related to the applied radiation dose, this study aimed to evaluate low-dose cochlear imaging with a photon-counting detector by investigating the accuracy of pre- and postoperative cochlear analysis., Materials and Methods: Photon-counting CT images of 10 temporal bone specimens were acquired with 3 different radiation dose levels (regular dose: 27.1 mGy, low dose: 4.81 mGy, and ultra-low dose: 3.43 mGy) before and after cochlear implant electrode carrier insertion. A clinical scan protocol was used with a tube potential of 120 kV in ultra-high-resolution scan mode (detector collimation 120 × 0.2 mm). The accuracy of cochlear duct length measurements for the organ of Corti and electrode contact determination was investigated for all applied settings by 2 independent otosurgeons., Results: No substantial differences were ascertained between photon-counting CT scans performed with standard dose and dedicated low-dose imaging regarding the accuracy of neither pre- and postoperative cochlear analysis nor postoperative cochlear implant electrode analysis. Radiation dose reduction of 82.3% (low dose) and 87.3% (ultra-low dose) could be realized compared with the clinical standard protocol., Conclusions: Ultra-high-resolution cochlear imaging is feasible with very low radiation exposure when using a first-generation photon-counting CT in combination with dedicated low-dose protocols. The accuracy of pre- and postoperative cochlear analysis with the applied dose reduction settings was comparable with a clinical regular-dose protocol., (© 2025 by American Journal of Neuroradiology.)