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1

Sudhoff, Holger, Hans Björn Gehl, Ercan Boga, Stefan Müller, Katharina Wilms, Sven Mutze, and Ingo Todt. "Stapes Prosthesis Length: One Size Fits All?" Audiology and Neurotology 24, no. 1 (2019): 1–7. http://dx.doi.org/10.1159/000494915.

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Background: The insertion of the stapes piston into the vestibule provides the physical basis for a successful stapedotomy. In routine clinical practice, two different ways to handle prosthesis length are performed: (1) an individualized measurement of the stapes prosthesis length or (2) a standard prosthesis length for all cases. Objective: The objective of this study was to compare both ways of handling prosthesis length and the effect of these methods on insertional prosthesis depth. Material and Method: We retrospectively evaluated 39 patients after performing a stapedotomy for radiologically estimated vestibular stapes prosthesis insertion depth. The individual measured length data were hypothetically changed to a standard length of 4.75, 5, 5.25, and 5.5 mm, and the insertion depths were compared. Results: The individually measured prosthesis lengths led to an insertion depth between 0.2 and 1.6 mm (mean 0.74 mm). The ratio of insertion depth/vestibular depth was between 8 and 59.1% (mean 26.6%). The different assumed standard lengths led to different rates of the vestibulum positions and possible bony contacts at the vestibulum floor. Conclusion: The individual measurement led to a zero rate of the vestibulum positions of stapes prosthesis pistons with a low insertion depth/vestibular depth ratio.
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Lee, Chang Yong, Won Bae Lee, Yun Mo Yeon, Keun Song, Jeong Hoon Moon, Jung Gu Kim, and Seung Boo Jung. "Joint Characteristics of Spot Friction Stir Welded 5052 Al Alloy Sheet." Advanced Materials Research 15-17 (February 2006): 345–50. http://dx.doi.org/10.4028/www.scientific.net/amr.15-17.345.

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The microstructure and mechanical properties of spot friction stir welded A 5052 alloy were investigated with insertion depth of welding tool. As the insertion depth of welding tool increased, the size of stirring zone increased and the thickness of upper sheet decreased. The value of shear load was the lowest at the shallowest insertion depth and increased to the highest value of 3.35 kN at a 1.6mm of insertion depth. An increase in the pin insertion depth beyond 1.6mm did not result in further increase in the lap shear load. Spot friction stir welded joints showed shear fracture mode at shallower insertion depths and fracture mode changed to plug fracture mode as the insertion depth was deeper.
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3

Shek, K. T., and David C. C. Lam. "Insertion Behavior of Microneedles for Drug Delivery." Advanced Materials Research 47-50 (June 2008): 1442–45. http://dx.doi.org/10.4028/www.scientific.net/amr.47-50.1442.

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Drug dosage delivered by drug-coated microneedle is dependent on needle insertion behavior. The insertion length and gripping force at varied insertion speeds are determined quantitatively using a precision test frame. The ratio of inserted depth to pressed depth was found to rise asymptotically to a plateau, but decreased rapidly to zero insertion when the needles are pressed less than 1000 microns deep for both silicone rubber and porcine skin. No insertion was observed when the needles are pressed less than 200 microns. The gripping force exerted onto the inserted needle by the skin decreased by 0.1N per mm of needle diameter and insertion depth. The short insertion depth and low force suggest that drug delivery using short 300 micron microneedles would be tenuous. High insertion speeds can help to improve drug delivery, but the improvement is limited to large needles since the results from this study showed that insertions become speedindependent when the needle diameter is less than 130 microns.
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4

Wilmes, Benedict, and Dieter Drescher. "Impact of Insertion Depth and Predrilling Diameter on Primary Stability of Orthodontic Mini-implants." Angle Orthodontist 79, no. 4 (July 1, 2009): 609–14. http://dx.doi.org/10.2319/071708-373.1.

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Abstract Objective: To test the hypothesis that the impact of the insertion depth and predrilling diameter have no effect on the primary stability of mini-implants. Materials and Methods: Twelve ilium bone segments of pigs were embedded in resin. After implant site preparation with different predrilling diameters (1.0, 1.1, 1.2, and 1.3 mm), Dual Top Screws 1.6 × 10 mm (Jeil, Korea) were inserted with three different insertion depths (7.5, 8.5, and 9.5 mm). The insertion torque was recorded to assess primary stability. In each bone, five Dual Top Screws were used as a reference to compensate for the differences of local bone quality. Results: Both insertion depth and predrilling diameter influenced the measured insertion torques distinctively: the mean insertion torque for the insertion depth of 7.5 mm was 51.62 Nmm (±25.22); for insertion depth of 8.5 mm, 65.53 Nmm (±29.99); and for the insertion depth of 9.5 mm, 94.38 Nmm (±27.61). The mean insertion torque employing the predrill 1.0 mm was 83.50 Nmm (±33.56); for predrill 1.1 mm, 77.50 Nmm (±27.54); for the predrill 1.2 mm, 61.70 Nmm (±28.46); and for the predrill 1.3 mm, 53.10 (±32.18). All differences were highly statistically significant (P < .001). Conclusions: The hypothesis is rejected. Higher insertion depths result in higher insertion torques and thus primary stability. Larger predrilling diameters result in lower insertion torques.
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Maiwald, Christian Achim, Patrick Neuberger, Ingo Mueller-Hansen, Rangmar Goelz, Jörg Michel, Michael Esser, Corinna Engel, Axel R. Franz, and Christian F. Poets. "Nasal insertion depths for neonatal intubation." Archives of Disease in Childhood - Fetal and Neonatal Edition 105, no. 6 (June 22, 2020): 663–65. http://dx.doi.org/10.1136/archdischild-2020-319140.

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AimData on the depth of nasal intubation in neonates are rare, although this is the preferred route in some countries. Therefore, recommendations on optimal nasal intubation depths based on gestational age (GA) and weight are desirable.MethodsWe determined the distances between the middle of thoracic vertebrae 2 (T2) and the tip of the endotracheal tube in 116 X-rays from nasally intubated neonates. The intubation depth (tip to nostril distance) that was documented in the digital patient’s file was then corrected for this distance to reach an optimal nasal insertion depth. Results were plotted against the infant’s GA and weight.ResultsGA-based and birthweight-based charts and formulas for the nasal intubation depth in infants with a GA between 24 and 43 weeks and body weight between 400 and 4500 g were created.ConclusionsGenerated data may help in predicting optimal insertion depths for nasal intubation in neonates.
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Anschuetz, Lukas, Stefan Weder, Georgios Mantokoudis, Martin Kompis, Marco Caversaccio, and Wilhelm Wimmer. "Cochlear Implant Insertion Depth Prediction." Otology & Neurotology 39, no. 10 (December 2018): e996-e1001. http://dx.doi.org/10.1097/mao.0000000000002034.

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7

Vaughan, N., V. N. Dubey, M. Y. K. Wee, and R. Isaacs. "Devices for accurate placement of epidural Tuohy needle for Anaesthesia administration." Mechanical Sciences 5, no. 1 (January 2, 2014): 1–6. http://dx.doi.org/10.5194/ms-5-1-2014.

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Abstract. The aim of this project is to design two sterile devices for epidural needle insertion which can measure in real time (i) the depth of needle tip during insertion and (ii) interspinous pressure changes through a pressure measurement device as the epidural needle is advanced through the tissue layers. The length measurement device uses a small wireless camera with video processing computer algorithms which can detect and measure the moving needle. The pressure measurement device uses entirely sterile componenets including a pressure transducer to accurately measure syringe saline in mm Hg. The data from these two devices accurately describe a needle insertion allowing comparison or review of insertions. The data was then cross-referenced to pre-measured data from MRI or ultrasound scan to identify how ligemant thickness correlates to our measured depth and pressure data. The developed devices have been tested on a porcine specimen during insertions performed by experienced anaesthetists. We have obtained epidural pressures for each ligament and demonstrated functionality of our devices to measure pressure and depth of epidural needle during insertion. This has not previously been possible to monitor in real-time. The benefits of these devices are (i) to provide an alternative method to identify correct needle placement during the procedure on real patients. (ii) The data describing the speed, depth and pressure during insertion can be used to configure an epidural simulator, simulating the needle insertion procedure. (iii) Our pressure and depth data can be compared to pre-measured MRI and ultrasound to identify previously unknown links between epidural pressure and depth with BMI, obesity and body shapes.
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8

Mulligan, Renae, Ling Yin, Anthony Lamont, Zhong Xiao Peng, Mark R. Forwood, and Swee Hin Teoh. "Effect of Penetration Rate on Insertion Force in Trabecular Bone Biopsy." Materials Science Forum 654-656 (June 2010): 2225–28. http://dx.doi.org/10.4028/www.scientific.net/msf.654-656.2225.

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Bone biopsy is a common procedure in bone disease diagnoses, therapies and research. In this procedure, bone biopsy needles are inserted into bone tissues. Although needle insertion into bone is often essential for the diagnosis of bone diseases, the hard tissue-needle interactions are not quantitatively understood. In this paper, we describe a quantitative assessment of forces involved in insertion of healthy trabecular bone using clinically applied Jamshidi CrownTM bone biopsy needles of gauge 8 (4-mm diameter). The measured forces were related to the insertion depths up to 25 mm and insertion rates of 1 mm/s to 5 mm/s. At the initial insertion stage, a clear linear force-depth relation was measured. With the increase of the insertion depth, the forces increased nonlinearly. In the final stage of insertion, the forces increased much more quickly at the lower insertion rate than that at the higher insertion rate. The maximum insertion force reached approximately 1000 N when the insertion depth reached 25 mm at the insertion rate of 1 mm/s.
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9

Krishnappa, Sudeep, and Pankaj Kundra. "Optimal anaesthetic depth for LMA insertion." Indian Journal of Anaesthesia 55, no. 5 (2011): 504. http://dx.doi.org/10.4103/0019-5049.89887.

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10

Tyndall, Erin R., Richard L. Gill, Kumaran S. Ramamurthi, and Fang Tian. "Membrane Insertion Depth and Curvature Sensing." Biophysical Journal 108, no. 2 (January 2015): 253a. http://dx.doi.org/10.1016/j.bpj.2014.11.1399.

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11

Althoefer, Kaspar, Bruno Lara, and Lakmal D. Seneviratne. "Monitoring of Self-Tapping Screw Fastenings Using Artificial Neural Networks." Journal of Manufacturing Science and Engineering 127, no. 1 (February 1, 2005): 236–43. http://dx.doi.org/10.1115/1.1831286.

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Screw fastenings account for a quarter of all assembly operations and automation of the process is highly desirable. This paper presents a novel strategy for monitoring this manufacturing process, focusing on the insertion of self-tapping screws. An artificial neural network (ANN), using “Torque-versus-Insertion-Depth” signature signals as input, is designed to distinguish between successful and failed insertions. The ANN is first tested using simulation data from an analytical model for screw insertions, and then validated using experimental torque signals obtained from an electric screwdriver. The results demonstrate that ANNs can effectively monitor the screw fastening process and cope with a wide range of insertion cases interpolating for unseen insertion signals.
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12

Ulguim, Rafael Da Rosa, Carine Mirela Vier, Felipe Betiolo, Pedro Ernesto Sbardella, Mari Lourdes Bernardi, Ivo Wentz, Ana Paula Mellagi, and Fernando Pandolfo Bortolozzo. "Insertion of an intrauterine catheter for post-cervical artificial insemination in gilts: a case report." Semina: Ciências Agrárias 39, no. 6 (November 30, 2018): 2833. http://dx.doi.org/10.5433/1679-0359.2018v39n6p2833.

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The aim of this case report was to characterize the insertion of an intrauterine catheter (IC) in gilts to perform post-cervical artificial insemination (PCAI). Attempts to insert ICs through the cervixes of gilts were performed using either a standard sow foam tip catheter (SFC; n = 25) or a standard gilt foam tip catheter (GFC; n = 25). The percentage of passage, depth and degree of difficulty for insertion were evaluated. The average depth of IC insertion was 10.1 ± 1.3 cm for SFC and 10.0 ± 1.2 cm for GFC. For both catheters, insertion depths of greater than 10 cm were achieved in the first insemination in 44% of gilts. Insertion depths of greater than 6 cm were observed in 72% and 60% of attempts using SFC and GFC, respectively. A high level of difficulty for IC insertion was observed, mainly while using GFC. In conclusion, the routine application of PCAI in gilts on swine farms remains limited by the low success rate for intrauterine catheter insertion. In further studies, we suggest evaluating reproductive performance using low insertion depths for PCAI in gilts, and assessing the use of sow foam tip catheter as a guide to introduce the IC.
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13

Nucera, Riccardo, Antonino Lo Giudice, Angela Mirea Bellocchio, Paola Spinuzza, Alberto Caprioglio, Letizia Perillo, Giovanni Matarese, and Giancarlo Cordasco. "Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults." Angle Orthodontist 87, no. 5 (June 9, 2017): 745–51. http://dx.doi.org/10.2319/011117-34.1.

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ABSTRACT Objective: To analyze the buccal bone thickness, bone depth, and cortical bone depth of the mandibular buccal shelf (MBS) to determine the most suitable sites of the MBS for mini-screw insertion. Materials and Methods: The sample included cone-beam computed tomographic (CBCT) records of 30 adult subjects (mean age 30.9 ± 7.0 years) evaluated retrospectively. All CBCT examinations were performed with the i-CAT CBCT scanner. Each exam was converted into DICOM format and processed with OsiriX Medical Imaging software. Proper view sections of the MBS were obtained for quantitative and qualitative evaluation of bone characteristics. Results: Mesial and distal second molar root scan sections showed enough buccal bone for mini-screw insertion. The evaluation of bone depth was performed at 4 and 6 mm buccally to the cementoenamel junction. The mesial root of the mandibular second molar at 4 and 6 mm showed average bone depths of 18.51 mm and 14.14 mm, respectively. The distal root of the mandibular second molar showed average bone depths of 19.91 mm and 16.5 mm, respectively. All sites showed cortical bone depth thickness greater than 2 mm. Conclusions: Specific sites of the MBS offer enough bone quantity and adequate bone quality for mini-screw insertion. The insertion site with the optimal anatomic characteristics is the buccal bone corresponding to the distal root of second molar, with screw insertion 4 mm buccal to the cementoenamel junction. Considering the cortical bone thickness of optimal insertion sites, pre-drilling is always recommended in order to avoid high insertion torque.
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Mittmann, Philipp, Grit Rademacher, Sven Mutze, Frederike Hassepass, Arneborg Ernst, and Ingo Todt. "Evaluation of the Relationship between the NRT-Ratio, Cochlear Anatomy, and Insertions Depth of Perimodiolar Cochlear Implant Electrodes." BioMed Research International 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/706253.

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The position of the cochlear implant electrode array within the scala tympani is essential for an optimal postoperative hearing benefit. If the electrode array changes in between the scalae intracochlearly (i.e., from scala tympani to scala vestibuli), a reduced auditory performance can be assumed. We established a neural response telemetry-ratio (NRT-ratio) which corresponds with the scalar position of the electrodes but shows within its limits a variability. The aim of this study was to determine if insertion depth angle or cochlea size influences the NRT-ratio. The intraoperative electrophysiological NRT data of 26 patients were evaluated. Using a flat panel tomography system, the position of the electrode array was evaluated radiologically. The insertion depth angle of the electrode, the cochlea size, and the NRT-ratio were calculated postoperatively. The radiological results were compared with the intraoperatively obtained electrophysiological data (NRT-ratio) and statistically evaluated. In all patients the NRT-ratio, the insertion depth angle, and the cochlea size could be determined. A significant correlation between insertional depth, cochlear size, and the NRT-ratio was not found. The NRT-ratio is a reliable electrophysiological tool to determine the scalar position of a perimodiolar electrode array. The NRT-ratio can be applied independent from insertion depth and cochlear size.
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Morrel, William G., Jourdan T. Holder, Benoit M. Dawant, Jack H. Noble, and Robert F. Labadie. "Effect of Scala Tympani Height on Insertion Depth of Straight Cochlear Implant Electrodes." Otolaryngology–Head and Neck Surgery 162, no. 5 (February 25, 2020): 718–24. http://dx.doi.org/10.1177/0194599820904941.

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Objective Studies suggest lateral wall (LW) scala tympani (ST) height decreases apically, which may limit insertion depth. No studies have investigated the relationship of LW ST height with translocation rate or location. Study Design Retrospective review. Setting Cochlear implant program at tertiary referral center. Subjects and Methods LW ST height was measured in preoperative images for patients with straight electrodes. Scalar location, angle of insertion depth (AID), and translocation depth were measured in postoperative images. Audiologic outcomes were tracked. Results In total, 177 ears were identified with 39 translocations (22%). Median AID was 443° (interquartile range [IQR], 367°-550°). Audiologic outcomes (126 ears) showed a small, significant correlation between consonant-nucleus-consonant (CNC) word score and AID ( r = 0.20, P = .027), although correlation was insignificant if translocation occurred ( r = 0.11, P = .553). Translocation did not affect CNC score ( P = .335). AID was higher for translocated electrodes (503° vs 445°, P = .004). Median translocation depth was 381° (IQR, 222°-399°). Median depth at which a 0.5-mm electrode would not fit within 0.1 mm of LW was 585° (IQR, 405°-585°). Median depth at which a 0.5-mm electrode would displace the basilar membrane by ≥0.1 mm was 585° (IQR, 518°-765°); this was defined as predicted translocation depth (PTD). Translocation rate was 39% for insertions deeper than PTD and 14% for insertions shallower than PTD ( P = .008). Conclusion AID and CNC are directly correlated for straight electrodes when not translocated. Translocations generally occur around 380° and are more common with deeper insertions due to decreasing LW ST height. Risk of translocation increases significantly after 580°.
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Brata, Akas Sureng, Keiji Sasaki, and Shigeyuki Shimachi. "Cylinder Insertion into Hole of Flexible Rubber Plate - Insertion Force Related to Position and Posture of Cylinder -." Journal of Robotics and Mechatronics 10, no. 3 (June 20, 1998): 191–96. http://dx.doi.org/10.20965/jrm.1998.p0191.

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We discuss cylinder insertion into a hole of a flexible rubber plate. Rubber plate deformation is modeled using long beams aligned perpendicular to the hole. Insertion force is analyzed in relation to cylinder depth, offset and inclination. Insertion force forms a hyperbolic field in three-dimensional space composed of position and posture parameter coordinates. The magnitude of insertion force is discussed based on insertion trajectory in the hyperbolic field. A human inserting a cylinder might angle it at the start of insertion, making it perpendicular to the rubber surface at the end. The human's sequence uses a trajectory that minimizes insertion force. We show experimentally a hyperbolic field in position and posture space.
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17

Guidera, A. K., L. Benoiton, L. McManus, and P. J. D. Dawes. "Subannular tube insertion: anatomical considerations." Journal of Laryngology & Otology 130, no. 1 (November 16, 2015): 69–75. http://dx.doi.org/10.1017/s0022215115003072.

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AbstractObjectives:To assess the distance between the bony groove created during subannular tubes placement and the chorda tympani, and examine the depth of the hypotympanum and retrotympanum.Method:Grooves drilled in cadaver temporal bones at two levels were imaged to measure: the distance between the chorda tympani nerve and the tympanic sulcus, and the depth of the hypotympanum and the retrotympanum relative to the annulus.Results:The chorda tympani was between 0 and 5 mm from the groove cut across the annulus. The hypotympanum average depth was 2 mm (0.44–6.40 mm) and the retrotympanum average depth was 1 mm (0–2.53 mm).Conclusion:Grooves drilled across the tympanic sulcus should be placed at a point 20 per cent of the height of the tympanic membrane or lower; this will ensure least risk of injury to the chorda tympani nerve. The depth of the hypotympanum and retrotympanum dictates that the posteroinferior part of a subannular tube flange should be approximately 2 × 1 mm.
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Hoenecke, Heinz, William Butcher, Shantanu S. Patil, Nikolai Steklov, Brad Tucker, William Bugbee, Clifford W. Colwell, and Darryl D. D’lima. "Osteochondral graft transplantation: relationship between graft insertion depth, insertion forces, cell death, and matrix degeneration (SS-41)." Arthroscopy: The Journal of Arthroscopic & Related Surgery 20 (May 2004): e19. http://dx.doi.org/10.1016/j.arthro.2004.02.051.

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19

Fendos, Justin, Francisco N. Barrera, and Donald M. Engelman. "Aspartate Embedding Depth Affects pHLIP’s Insertion pKa." Biochemistry 52, no. 27 (June 27, 2013): 4595–604. http://dx.doi.org/10.1021/bi400252k.

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20

Fielden, C., C. Long, H. Cooper, D. Proops, I. Donaldson, and L. Craddock. "Insertion depth differences in bilateral cochlear implantees." Cochlear Implants International 6, sup1 (September 2005): 17–20. http://dx.doi.org/10.1179/cim.2005.6.supplement-1.17.

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21

Gil Mun, Sang, Evgenia Scheffner, Stephan Müller, Philipp Mittmann, Grit Rademacher, Sven Mutze, Katharina Wilms, et al. "Stapes piston insertion depth and clinical correlations." Acta Oto-Laryngologica 139, no. 10 (July 12, 2019): 829–32. http://dx.doi.org/10.1080/00016489.2019.1637019.

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Fielden, C., C. Long, H. Cooper, D. Proops, I. Donaldson, and L. Craddock. "Insertion depth differences in bilateral cochlear implantees." Cochlear Implants International 6, S1 (September 2005): 17–20. http://dx.doi.org/10.1002/cii.275.

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23

El-Orbany, Mohammad, and M. Ramez Salem. "Confirmatory tests for endotracheal tube insertion depth." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 61, no. 8 (June 10, 2014): 770–71. http://dx.doi.org/10.1007/s12630-014-0180-3.

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Eldawlatly, AbdelazeemA. "Double lumen tube: Size and insertion depth." Saudi Journal of Anaesthesia 15, no. 3 (2021): 280. http://dx.doi.org/10.4103/sja.sja_192_21.

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Deshpande, Shweta, Neelam Vaid, Dzemal Gazibegovic, and Ajimsha KM. "Comparison of Insertion Depth and Hearing Preservation Results between HiFocus 1j and HiFocus Mid-Scala Electrodes in Pediatric Population." Annals of Otology and Neurotology 01, no. 02 (September 2018): 068–76. http://dx.doi.org/10.1055/s-0038-1677053.

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Abstract Background Various electrodes are available with a range of features and designs to fulfil anatomical and geometrical variations of the cochlea. The HiFocus 1j (1j) electrode developed by Advanced Bionics LLC is a lateral wall electrode designed to cover up to 1.5 turns or approximately 540° of the cochlea. The HiFocus Mid-Scala (HFms) was recently introduced and designed for structure preservation with a target insertion depth of 420°. Objective To evaluate the average insertion depth and variation, and to assess the potential for hearing preservation with 1j and HFms electrodes in children. Method A group of prelingually deafened children with regular anatomy who received the HiRes90K implant (either 1j or HFms electrode) underwent a plain radiography investigation shortly after the surgery to determine the angular insertion depth. The median age in each group was 3.6 years (1j) and 4.3 years (HFms). The amount of residual hearing was measured through audiometry prior surgery and then monitored at device activation and 1,3, 6, and 12 months later. Results Seventeen subjects were included for calculation of insertion depth. The median insertion depth and the variation for the 1j electrode was higher than for the HFms electrode (1j 476°; 443°–540°, HFms 413°; 390°–468°). Only eleven subjects were assessed for hearing preservation. Complete hearing preservation was achieved in seven subjects (five HFms and two 1j) and partial loss was observed in two subjects (one HFms and one 1j). Conclusion Both 1j and HFms electrodes are suitable for young children. Their flexible design allows round window insertions. The HFms group showed higher rates of hearing preservation (HP) than the 1j group.
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Marulasiddappa, Vinay, and Raghavendra Biligiri Sridhara. "Comparison of Topographic and Formula Methods for Depth of Insertion of Central Venous Catheters." Indian Journal of Anesthesia and Analgesia 6, no. 3 (2019): 801–5. http://dx.doi.org/10.21088/ijaa.2349.8471.6319.16.

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Franke-Trieger, Annett, and Dirk Mürbe. "Estimation of insertion depth angle based on cochlea diameter and linear insertion depth: a prediction tool for the CI422." European Archives of Oto-Rhino-Laryngology 272, no. 11 (November 2, 2014): 3193–99. http://dx.doi.org/10.1007/s00405-014-3352-4.

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M., Bosque, Siquella M., Monclús P., and Santafe MM. "Assessment of needle penetration depth and relationship with its analgesic effect." Revista Fisioterapia Invasiva / Journal of Invasive Techniques in Physical Therapy 02, no. 02 (December 2019): 079. http://dx.doi.org/10.1055/s-0039-3401861.

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Abstract Background and Aims The field of invasive physical therapy offers a wide spectrum of effective methods for the treatment of myofascial pain. All these methods share the fact that they begin with the insertion of a solid needle. Thereafter, they diverge either because of the variable use of repeated insertions or because of the application of an electric current with different intensity and duration parameters. The so-called “needle effect” is described as an anesthetic effect which is achieved by probing with the needle the point where pain pressure sensitivity is found, using an appropriate orientation and depth in order to elicit this effect. At present, there continues to be controversy regarding whether the needle effect is a true clinical effect or placebo. Material and Methods This study is a controlled clinical trial with double blinding formed by three randomized groups: sham needling, needling at the level of the subcutaneous tissue (superficial) and needling at the level of the muscle tissue (deep). The intervention consisted in the insertion of the needle at the specified depth according to each group and maintained during 60 seconds. Each group comprised of 17 volunteer inline hockey players of both sexes from the Club Reus Deportiu sports club in the junior and senior categories (between 18 and 36 years of age). Algometry and joint range of motion were determined for the dominant lower limb before and after the intervention. A Student's t-test was performed for paired comparisons and an ANOVA for multiple comparisons. Results The same degree of algometry and joint range variation was obtained before and after the intervention in the three groups under study. No significant differences regarding algometry or joint range were obtained between the group of superficial needle insertion compared to the deep dry needling group, nor for any of these groups compared to the sham group. Conclusion No improvement was found in the pain pressure sensitivity in a latent Myofascial Trigger Point (MTrP) of the gastrocnemius muscle nor were there improvements in dorsal and plantar ankle flexion immediately after treatment for any of the needle depths studied. The mere insertion of an acupuncture needle in a MTrP in young athletes does not provide any therapeutic benefit within the study parameters. Therefore, it seems reasonable that repeated insertions or specific techniques should be used to achieve a beneficial effect.
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Pile, J., G. B. Wanna, and N. Simaan. "Robot-assisted perception augmentation for online detection of insertion failure during cochlear implant surgery." Robotica 35, no. 7 (June 9, 2016): 1598–615. http://dx.doi.org/10.1017/s0263574716000333.

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SUMMARYDuring the past decade, robotics for cochlear implant electrode array insertion has been limited to manipulation assistance. Going beyond manipulation assistance, this paper presents the new concept of perception augmentation to detect and warn against the onset of intracochlear electrode array tip folding. This online failure detection method uses a combination of intraoperative electrode insertion force data and a predictive model of insertion force profile progression as a function of insertion depth. The predictive model uses statistical characterization of insertion force profiles during normal robotic electrode array insertions as well as the history of intra-operative insertion forces. Online detection of onset of tip folding is achieved using the predictive model as an input into a support vector machine classifier. Results show that the detection of tip folding onset can be achieved with an accuracy of 88% despite the use of intra-operative insertion force data representing incomplete insertion. This result is significant because it allows the surgeon or robot to choose a corrective action for preventing intra-cochlear complications.
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Wilmer, Alexander, and Paul Rutgeerts. "Push Enteroscopy: Technique, Depth, and Yield of Insertion." Gastrointestinal Endoscopy Clinics of North America 6, no. 4 (October 1996): 759–76. http://dx.doi.org/10.1016/s1052-5157(18)30340-4.

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Craig, F., J. Stroobant, A. Winrow, and H. Davies. "Depth of insertion of a lumbar puncture needle." Archives of Disease in Childhood 77, no. 5 (November 1, 1997): 450. http://dx.doi.org/10.1136/adc.77.5.450.

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LI, A. M., and T. FENTON. "Depth of insertion of a lumbar puncture needle." Archives of Disease in Childhood 80, no. 1 (January 1, 1999): 100. http://dx.doi.org/10.1136/adc.80.1.100g.

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Adunka, Oliver, and Jan Kiefer. "Impact of electrode insertion depth on intracochlear trauma." Otolaryngology–Head and Neck Surgery 135, no. 3 (September 2006): 374–82. http://dx.doi.org/10.1016/j.otohns.2006.05.002.

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Farooq, M., J. H. Bahk, and J. T. Kim. "Bedside prediction of central venous catheter insertion depth." British Journal of Anaesthesia 98, no. 5 (April 2007): 695–96. http://dx.doi.org/10.1093/bja/aem081.

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Buchman, Craig A., Margaret T. Dillon, English R. King, Marcia C. Adunka, Oliver F. Adunka, and Harold C. Pillsbury. "Influence of Cochlear Implant Insertion Depth on Performance." Otology & Neurotology 35, no. 10 (December 2014): 1773–79. http://dx.doi.org/10.1097/mao.0000000000000541.

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Schulze-Bonhage, A., D. Dennig, K. Wagner, J. Cordeiro, A. Carius, S. Fauser, and M. Trippel. "Seizure control resulting from intrahippocampal depth electrode insertion." Journal of Neurology, Neurosurgery & Psychiatry 81, no. 3 (February 25, 2010): 352–53. http://dx.doi.org/10.1136/jnnp.2009.180075.

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37

Mitsuda, Shingo, Kiyoshi Moriyama, and Tomoko Yorozu. "Optimal insertion depth of endotracheal tube among Japanese." Journal of Anesthesia 28, no. 3 (November 7, 2013): 477. http://dx.doi.org/10.1007/s00540-013-1739-9.

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Mittmann, P., A. Ernst, and I. Todt. "Electrode design and insertional depth-dependent intra-cochlear pressure changes: a model experiment." Journal of Laryngology & Otology 132, no. 3 (November 6, 2017): 224–29. http://dx.doi.org/10.1017/s0022215117002195.

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AbstractBackground:Preservation of residual hearing is one of the major goals in modern cochlear implant surgery. Intra-cochlear fluid pressure changes influence residual hearing, and should be kept low before, during and after cochlear implant insertion.Methods:Experiments were performed in an artificial cochlear model. A pressure sensor was inserted in the apical part. Five insertions were performed on two electrode arrays. Each insertion was divided into three parts, and statistically evaluated in terms of pressure peak frequency and pressure peak amplitude.Results:The peak frequency over each third part of the electrode increased in both electrode arrays. A slight increase was seen in peak amplitude in the lateral wall electrode array, but not in the midscalar electrode array. Significant differences were found in the first third of both electrode arrays.Conclusion:The midscalar and lateral wall electrode arrays have different intra-cochlear fluid pressure changes associated with intra-cochlear placement, electrode characteristics and insertion.
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Cisneros Lesser, Juan Carlos, Rubens de Brito, Graziela de Souza Queiroz Martins, Eloisa Maria Mello Santiago Gebrim, and Ricardo Ferreira Bento. "Evaluating Intracochlear Trauma after Cochlear Implant Electrode Insertion through Middle Fossa Approach in Temporal Bones." Otolaryngology–Head and Neck Surgery 158, no. 2 (October 31, 2017): 350–57. http://dx.doi.org/10.1177/0194599817739837.

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Objective To evaluate cochlear trauma after cochlear implant insertion through a middle fossa approach by means of histologic and imaging studies in temporal bones. Study Design Prospective cadaveric study. Setting University-based temporal bone laboratory. Subjects and Methods Twenty fresh-frozen temporal bones were implanted through a middle cranial fossa basal turn cochleostomy. Ten received a straight electrode and 10 a perimodiolar electrode. Samples were fixed in epoxy resin. Computed tomography (CT) scans determined direction, depth of insertion, and the cochleostomy to round window distance. The samples were polished by a microgrinding technique and microscopically visualized to evaluate intracochlear trauma. Descriptive and analytic statistics were performed to compare both groups. Results The CT scan showed intracochlear insertions in every bone, 10 directed to the middle/apical turn and 10 to the basal turn. In the straight electrode group, the average number of inserted electrodes was 12.3 vs 15.1 for the perimodiolar group ( U = 78, P = .0001). The median insertion depth was larger for the perimodiolar group (14.4 mm vs 12.5 mm, U = 66, P = .021). Only 1 nontraumatic insertion was achieved and 14 samples (70%) had important trauma (Eshraghi grades 3 and 4). No differences were identified comparing position or trauma grades for the 2 electrode models or when comparing trauma depending on the direction of insertion. Conclusion The surgical technique allows a proper intracochlear insertion, but it does not guarantee a correct scala tympani position and carries the risk of important trauma to cochlear microstructures.
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Moreira, Pedro, Leanne Kuil, Pedro Dias, Ronald Borra, and Sarthak Misra. "Tele-Operated MRI-Guided Needle Insertion for Prostate Interventions." Journal of Medical Robotics Research 04, no. 01 (March 2019): 1842003. http://dx.doi.org/10.1142/s2424905x18420035.

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Prostate cancer is one of the leading causes of death in men. Prostate interventions using magnetic resonance imaging (MRI) benefits from high tissue contrast if compared to other imaging modalities. The Minimally Invasive Robotics In An MRI environment (MIRIAM) robot is an MRI-compatible system able to steer different types of needles towards a point of interest using MRI guidance. However, clinicians can be reluctant to give the robot total control of the intervention. This work integrates a haptic device in the MIRIAM system to allow input from the clinician during the insertion. A shared control architecture is achieved by letting the clinician control the insertion depth via the haptic device, while the robotic system controls the needle orientation. The clinician receives haptic feedback based on the insertion depth and tissue characteristics. Four control laws relating the motion of the master robot (haptic device) to the motion of the slave robot (MIRIAM robot) are presented and evaluated. Quantitative and qualitative results from 20 human subjects demonstrate that the squared-velocity control law is the most suitable option for our application. Additionally, a pre-operative target localization algorithm is presented in order to provide the robot with the target location. The target localization and reconstruction algorithm are validated in phantom and patient images with an average dice similarity coefficient (DSC) of 0.78. The complete system is validated through experiments by inserting a needle towards a target within the MRI scanner. Four human subjects perform the experiment achieving an average targeting error of 3.4[Formula: see text]mm.
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Kosaka, Mariko, Yoshimasa Oyama, Tetsuya Uchino, Yojiro Ogihara, Hironori Koga, Chihiro Shingu, Shigekiyo Matsumoto, and Takaaki Kitano. "Ultrasound-guided central venous tip confirmation via right external jugular vein using a right supraclavicular fossa view." Journal of Vascular Access 20, no. 1 (May 3, 2018): 19–23. http://dx.doi.org/10.1177/1129729818771886.

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Introduction: Ultrasound-guided central venous catheter tip confirmation has a potential to precisely locate the central venous catheter, preventing its misplacement, using real-time guidance. This observational study sought to determine the accuracy of central venous catheter tip positioning via the external jugular vein via a supraclavicular fossa view under ultrasound guidance. Methods: In total, 77 patients scheduled for central venous catheter insertion via the right external jugular vein were enrolled. The depth of central venous catheter insertion was determined by advancing the tip of the guidewire to the junction of the superior vena cava and right pulmonary artery, using a right supraclavicular fossa view ultrasound method. We determined the reference insertion depth to the carina using a postoperative chest x-ray photograph method. We then compared insertion depths obtained by the ultrasound and x-ray photograph methods and body-height formula. Results: In total, 62 patients were able to advance the guidewire and underwent ultrasound-guided central venous catheter insertion. In four patients, we corrected for misplaced guidewires. According to Bland–Altman plots, the insertion depth was 0.88 cm shorter for the ultrasound method (95% limits of agreement, −1.66 to 3.41 cm) and 0.90 cm shorter for the formulaic method (95% limits of agreement, −2.77 to 4.56 cm), compared with the x-ray photograph method. The x-ray photograph method had significantly positive correlations with the ultrasound (r = 0.73) and formulaic methods (r = 0.27). Conclusion: A right supraclavicular fossa view improves the accuracy of central venous catheter tip positioning and prevents central venous catheter misplacement via the right external jugular vein.
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Moon, Youngjin, and Jaesoon Choi. "Characteristics of Needle Insertion Performance of Automated Biopsy Device for Robotic Needle Insertion Type Intervention: Insertion Depth and Accuracy." Journal of the Korean Society for Precision Engineering 33, no. 7 (July 1, 2016): 565–70. http://dx.doi.org/10.7736/kspe.2016.33.7.565.

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43

Seneviratne, L. D., F. A. Ngemoh, and S. W. E. Earles. "An experimental investigation of torque signature signals for self-tapping screws." Proceedings of the Institution of Mechanical Engineers, Part C: Journal of Mechanical Engineering Science 214, no. 2 (February 1, 2000): 399–410. http://dx.doi.org/10.1243/0954406001523065.

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The results of an experimental study on the self-tapping screw insertion process are presented. A test rig designed and constructed for measuring the torque signature signals during screw insertions is described. Experimental results for torque signature signals during general self-tapping screw fastenings are given graphically, confirming the five-stage variation with screw insertion depth predicted by an earlier theoretical study. The experimental data provide a basis for the further development of empirical and theoretical models of the self-tapping screw fastening process, in order to formulate and put into practice automated monitoring and control strategies.
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44

Gill, Irwin, Aisling Stafford, Madeleine C. Murphy, Aisling R. Geoghegan, Miranda Crealey, Eoghan Laffan, and Colm Patrick Finbarr O’Donnell. "Randomised trial of estimating oral endotracheal tube insertion depth in newborns using weight or vocal cord guide." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 4 (September 7, 2017): F312—F316. http://dx.doi.org/10.1136/archdischild-2017-312798.

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BackgroundWhen intubating newborns, clinicians aim to position the endotracheal tube (ETT) tip in the midtrachea. The depth to which ETTs should be inserted is often estimated using the infant’s weight. ETTs are frequently incorrectly positioned in newborns, most often inserted too far. Using the vocal cord guide (a mark at the distal end of the ETT) to guide insertion depth has been recommended.ObjectiveTo determine whether estimating ETT insertion depth using the vocal cord guide rather than weight results in more correctly positioned ETT tips.DesignSingle-centre randomised controlled trial.SettingLevel III neonatal intensive care unit (NICU) at a university maternity hospital (National Maternity Hospital, Dublin, Ireland).PatientsNewborn infants without congenital anomalies intubated in the NICU.InterventionsParticipants were randomised to have ETT insertion depth estimated using weight [insertion depth (cm) = weight (kg) +6] or vocal cord guide.Main outcome measureCorrect ETT position, that is, tip between the upper border of the first thoracic vertebra (T1) and the lower border of the second thoracic vertebra (T2) on a chest X-ray as determined by one paediatric radiologist masked to group assignment.Results136 participants were randomised. The proportion of correctly positioned ETTs was similar in both groups (weight 30/69 (44%) vs vocal cord guide 27/67 (40%), p=0.731). Most incorrectly positioned ETT (69/79, 87%) were too low.ConclusionEstimating ETT insertion depth using the vocal cord guide did not result in more correctly positioned ETT tips.Trial registration numberISRCTN39654846.
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Eldawlatly, Abdelazeem A., Mohamed R. El Tahan, Naveed U. Kanchi, Ahmad Al Qatari, and Abdulaziz E. Ahmad. "Efficacy of height-based formula to predict insertion depth of left-sided double lumen tube: A prospective observational study." Anaesthesia and Intensive Care 48, no. 5 (September 2020): 354–57. http://dx.doi.org/10.1177/0310057x20946051.

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The insertion depth of the left-sided double-lumen tube needs careful positioning and bronchoscopic confirmation. Several formulae based on body height have been used for estimating the optimal insertion depth of a left-sided double-lumen tube. We conducted this prospective study to test the hypothesis that our earlier developed height-based formula (0.25 × body height0.916) could predict the accurate insertion depth of a left-sided double-lumen tube. After obtaining ethical approval, 66 patients who underwent thoracic surgery were included. A left-sided double-lumen tube was advanced blindly to the predicted depth of insertion calculated using our formula. The optimal position of the left-sided double-lumen tube was confirmed using a fibreoptic bronchoscope. The primary outcome was the percentage of tubes placed in the optimal position without the need for further adjustments. The secondary outcomes included the need for bronchoscopic adjustments and the final correct insertion depth of the left-sided double-lumen tube. The formula resulted in an optimum position of the left-sided double-lumen tube without further adjustments in 45 patients (70%) (95% confidence interval 58%–80%). The left-sided double-lumen tube was withdrawn or advanced in 18.2% and 12.1%, respectively, to achieve the optimal insertion depth. We found that our formula provided satisfactory positioning in about 70% of patients and that in the remaining patients, the adjustments required to achieve satisfactory positioning under fibreoptic bronchoscope guidance were minimal. Nevertheless, as it is not possible to predict which patients will have a satisfactory tube position, bronchoscopic confirmation for the final positioning is still required.
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Noble, Anisha R., Erin Christianson, Susan J. Norton, Henry C. Ou, Grace S. Phillips, Hedieh Khalatbari, Seth D. Friedman, and David L. Horn. "Reliability of Measuring Insertion Depth in Cochlear Implanted Infants and Children Using Cochlear View Radiography." Otolaryngology–Head and Neck Surgery 163, no. 4 (May 26, 2020): 822–28. http://dx.doi.org/10.1177/0194599820921857.

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Objectives Cochlear implant depth of insertion affects audiologic outcomes and can be measured in adults using plain films obtained in the “cochlear view.” The objective of this study was to assess interrater and intrarater reliability of measuring depth of insertion using cochlear view radiography. Study Design Prospective, observational. Setting Tertiary referral pediatric hospital. Subjects and Methods Patients aged 11 months to 20 years (median, 4 years; interquartile range [IQR], 1-8 years) undergoing cochlear implantation at our institution were studied over 1 year. Children underwent cochlear view imaging on postoperative day 1. Films were deidentified and 1 image per ear was selected. Two cochlear implant surgeons and 2 radiologists evaluated each image and determined angular depth of insertion. Images were re-reviewed 6 weeks later by all raters. Inter- and intrarater reliability were calculated with intraclass correlation coefficients (ICCs). Results Fifty-seven ears were imaged from 42 children. Forty-nine ears (86%) had successful cochlear view x-rays. Median angular depth of insertion was 381° (minimum, 272°; maximum, 450°; IQR, 360°-395°) during the first round of measurement. Measurements of the same images reviewed 6 weeks later showed median depth of insertion of 382° (minimum, 272°; maximum, 449°; IQR, 360°-397°). Interrater and intrarater reliability ICCs ranged between 0.81 and 0.96, indicating excellent reliability. Conclusions Postoperative cochlear view radiography is a reliable tool for measurement of cochlear implant depth of insertion in infants and children. Further studies are needed to determine reliability of intraoperatively obtained cochlear view radiographs in this population.
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Callesen, Rasmus Eið, Cecilie Mullerup Kiel, Lisette Hvid Hovgaard, Kathrine Kronberg Jakobsen, Michael Papesch, Christian von Buchwald, and Tobias Todsen. "Optimal Insertion Depth for Nasal Mid-Turbinate and Nasopharyngeal Swabs." Diagnostics 11, no. 7 (July 14, 2021): 1257. http://dx.doi.org/10.3390/diagnostics11071257.

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Millions of people are tested for COVID-19 daily during the pandemic, and a lack of evidence to guide optimal nasal swab testing can increase the risk of false-negative test results. This study aimed to determine the optimal insertion depth for nasal mid-turbinate and nasopharyngeal swabs. The measurements were made with a flexible endoscope during the collection of clinical specimens with a nasopharyngeal swab at a public COVID-19 test center in Copenhagen, Denmark. Participants were volunteer adults undergoing a nasopharyngeal SARS-CoV-2 rapid antigen test. All 109 participants (100%) completed the endoscopic measurements; 52 (48%) women; 103 (94%) white; mean age 34.39 (SD, 13.2) years; and mean height 176.7 (SD, 9.29) cm. The mean swab length to the posterior nasopharyngeal wall was 9.40 (SD, 0.64) cm. The mean endoscopic distance to the anterior and posterior end of the inferior turbinate was 1.95 (SD, 0.61) cm and 6.39 (SD, 0.62) cm, respectively. The mean depth to nasal mid-turbinate was calculated as 4.17 (SD, 0.48) cm. The optimal depths of insertion for nasal mid-turbinate swabs are underestimated in current guidelines compared with our findings. This study provides clinical evidence to guide the performance of anatomically correct nasal and nasopharyngeal swab specimen collection for virus testing.
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Colby, C. C., N. W. Todd, H. R. Harnsberger, and P. A. Hudgins. "Standardization of CT Depiction of Cochlear Implant Insertion Depth." American Journal of Neuroradiology 36, no. 2 (October 22, 2014): 368–71. http://dx.doi.org/10.3174/ajnr.a4105.

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DIRKS, D., J. AHLSTROM, and L. EISENBERG. "Effects of probe insertion depth on real ear measurements." Otolaryngology - Head and Neck Surgery 110, no. 1 (January 1994): 64–74. http://dx.doi.org/10.1016/s0194-5998(94)70794-4.

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50

Riopelle, James. "Use of ultrasound to control depth of needle insertion." Regional Anesthesia and Pain Medicine 26, no. 4 (August 2001): 384. http://dx.doi.org/10.1053/rapm.2001.23217.

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