Insertional depth-dependent intracochlear pressure changes in a model of cochlear implantation

2016 ◽  
Vol 137 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Marlene Mittmann ◽  
Arneborg Ernst ◽  
Philipp Mittmann ◽  
Ingo Todt
Keyword(s):  
Cochlear Implantation ◽  
Intracochlear Pressure ◽  
Pressure Changes

Minimizing Intracochlear Pressure: Influence of the Insertion Sheath

2021 ◽  
pp. 1-6
Author(s):  
Ceyhun Ucta ◽  
Philipp Mittmann ◽  
Arneborg Ernst ◽  
Rainer Seidl ◽  
Gina Lauer
Keyword(s):  
Optical Sensor ◽  
Cochlear Implantation ◽  
Apical Part ◽  
Electrode Arrays ◽  
Insertion Technique ◽  
Cochlear Model ◽  
Electrode Insertion ◽  
Intracochlear Pressure ◽  
Pressure Changes

Objective: Atraumatic cochlear implantation (CI) and insertion of the electrode in particular are major goals of recent CI surgery. Perimodiolar electrode arrays need a stylet or exosheath for insertion. The sheath can influence the intracochlear pressure changes during insertion of the electrode. The aim of this study was to modify the insertion sheath to optimize intracochlear pressure changes. Methods: In an artifical cochlear model, 7 different modified insertion sheaths were used. The intracochlear pressure was measured with a micro-optical sensor in the apical part of the model cochlea. Results: Significant lower intracochlear pressure changes were observed when the apical part of the insertion sheath was either shortened or tapered. Modification of the stopper does influence the intracochlear pressure significantly. Conclusion: Modification of the insertion sheath leads to lower intracochlear pressure gain. The differences and impact on intracochlear pressure changes found in this study underline the importance of even subtle modifications of the electrode insertion technique.

The Effects of Gusher-Related Intracochlear Pressure Changes on Hearing Preservation in Cochlear Implantation: A Comparative Series

2018 ◽  
Vol 23 (3) ◽  
pp. 181-186 ◽  
Author(s):  
William Crohan ◽  
Jay Krishnaswamy ◽  
Gunesh Rajan
Keyword(s):  
Cochlear Implantation ◽  
Large Change ◽  
Lateral Wall ◽  
Hearing Preservation ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Significant Drop ◽  
Speech Performance ◽  
Intracochlear Pressure ◽  
Pressure Changes

Aim: To investigate and compare residual hearing preservation between patients based on the presence of intraoperative gusher. Methodology: We retrospectively compared 2 cohorts of cochlear implant recipients significantly distinguished by whether or not they experienced gusher intraoperatively. Patients underwent cochlear implantation using 24-mm lateral wall electrode arrays as well pharmacologic steroid protection. All patients were assessed by a hearing implant MDT. Hearing preservation rates and speech perception outcomes were assessed at 1, 6, 12, 24, 36, 48, and 60 months. Results: The patients with no gusher demonstrated complete hearing preservation. The patients with gusher demonstrated significant postoperative reduction of hearing thresholds, which declined at a significantly higher pace during follow-up. All patients demonstrated significantly better speech performance after cochlear implantation. Conclusion: The present study suggests that intraoperative gusher is associated with a significant drop in residual hearing, both immediately and over time, which may be related to the large change in intracochlear pressure intraoperatively.

scholarly journals Postinsertional Cable Movements of Cochlear Implant Electrodes and Their Effects on Intracochlear Pressure

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
I. Todt ◽  
D. Karimi ◽  
J. Luger ◽  
A. Ernst ◽  
P. Mittmann
Keyword(s):  
Cochlear Implantation ◽  
Maximum Amplitude ◽  
Storage Conditions ◽  
Mastoid Cavity ◽  
Maximum Pressure ◽  
Apical Region ◽  
Pressure Amplitude ◽  
Lower Maximum ◽  
Intracochlear Pressure ◽  
Pressure Changes

Introduction.To achieve a functional atraumatic cochlear implantation, intracochlear pressure changes during the procedure should be minimized. Postinsertional cable movements are assumed to induce intracochlear pressure changes. The aim of this study was to observe intracochlear pressure changes due to postinsertional cable movements.Materials and Methods.Intracochlear pressure changes were recorded in a cochlear model with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude and pressure gain velocity in intracochlear pressure. A temporal bone mastoid cavity was attached to the model to simulate cable positioning. The compared conditions were (1) touching the unsealed electrode, (2) touching the sealed electrode, (3) cable storage with an unfixed cable, and (4) cable storage with a fixed cable.Results.We found statistically significant differences in the occurrence of maximum amplitude and pressure gain velocity in intracochlear pressure changes under the compared conditions. Comparing the cable storage conditions, a cable fixed mode offers significantly lower maximum pressure amplitude and pressure gain velocity than the nonfixed mode.Conclusion.Postinsertional cable movement led to a significant pressure transfer into the cochlea. Before positioning the electrode cable in the mastoid cavity, fixation of the cable is recommended.

scholarly journals Intracochlear Pressure Changes After Cochlea Implant Electrode Pullback—Reduction of Intracochlear Trauma

2019 ◽  
Vol 4 (4) ◽  
pp. 441-445 ◽  
Author(s):  
Gina Lauer ◽  
Julica Uçta ◽  
Lars Decker ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlea Implant ◽  
Intracochlear Pressure ◽  
Pressure Changes

Effects of Different Insertion Techniques of a Cochlear Implant Electrode on the Intracochlear Pressure

2016 ◽  
Vol 21 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Ingo Todt ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlear Implant ◽  
Maximum Amplitude ◽  
Cochlear Model ◽  
Pressure Peak ◽  
Insertion Techniques ◽  
Intracochlear Pressure ◽  
Pressure Changes

To achieve a functional atraumatic insertion, low intracochlear pressure changes during the procedure are assumed to be important. The aim of this study was to observe intracochlear pressure changes due to different insertion techniques in a cochlear model. Cochlear implant electrode insertions were performed in an artificial cochlear model to record intracochlear pressure changes with a micropressure sensor to evaluate the maximum amplitude and frequency of pressure changes under different insertional conditions. We found statistically significant differences in the occurrence of intracochlear pressure peak changes comparing different techniques. Based on our model results, an insertion should be maximally supported to minimize micromovement-related pressure changes.

scholarly journals Effects of Round Window Opening Size and Moisturized Electrodes on Intracochlear Pressure Related to the Insertion of a Cochlear Implant Electrode

2016 ◽  
Vol 6 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Ingo Todt ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlear Implant ◽  
Round Window ◽  
Pressure Change ◽  
Hearing Preservation ◽  
Round Window Membrane ◽  
Cochlear Model ◽  
Window Opening ◽  
Hydrophilic Character ◽  
Intracochlear Pressure ◽  
Pressure Changes

Intracochlear pressure changes during the cochlear implant insertion are assumed to be an important contributor to hearing preservation. The aim was to observe intracochlear pressure changes by different round window opening sizes and different hydrophilic electrode conditions. The experiments were performed in a cochlear model with a micropressure sensor in the helicotrema area. Different artificial round window membrane and different moisturized electrode conditions were compared. A punctured round window causes a significantly higher and an indirect moisturized electrode condition a significantly lower intracochlear pressure change. The degree of round window opening and the hydrophilic character of an electrode during insertion affect the intracochlear pressure significantly in a model.

scholarly journals Cochlear implant electrode sealing techniques and related intracochlear pressure changes

2017 ◽  
Vol 46 (1) ◽  
Author(s):  
Ingo Todt ◽  
Julica Utca ◽  
Dania Karimi ◽  
Arne Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlear Implant ◽  
Intracochlear Pressure ◽  
Pressure Changes

scholarly journals Intracochlear Pressure Changes due to Round Window Opening: A Model Experiment

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
P. Mittmann ◽  
A. Ernst ◽  
I. Todt
Keyword(s):  
Model Experiment ◽  
Round Window ◽  
Pressure Change ◽  
Intraluminal Pressure ◽  
Round Window Membrane ◽  
Electrode Design ◽  
Residual Hearing ◽  
Window Opening ◽  
Intracochlear Pressure ◽  
Pressure Changes

To preserve residual hearing in cochlea implantation, the electrode design has been refined and an atraumatic insertion of the cochlea electrode has become one aspect of cochlea implant research. The opening of the round window can be assumed to be a contributing factor in an atraumatic concept. The aim of our study was to observe intracochlear pressure changes due to different opening conditions of an artificial round window membrane. The experiments were performed in an artificial cochlea model. A round window was simulated with a polythene foil and a pressure sensor was placed in the helicotrema area to monitor intraluminal pressure changes. Openings of the artificial round window membrane were performed using different ways. Opening the artificial round window mechanically showed a biphasic behaviour of pressure change. Laser openings showed a unidirectional pressure change. The lowest pressure changes were observed when opening the artificial round window membrane using a diode laser. The highest pressure changes were seen when using a needle. The openings with the CO2laser showed a negative intracochlear pressure and a loss of fluid. In our model experiments, we could prove that the opening of the artificial round window membrane causes various intracochlear pressure changes.

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