First Experience With a New Thin Lateral Wall Electrode in Human Temporal Bones

2019 ◽  
Vol 40 (7) ◽  
pp. 872-877 ◽  
Author(s):  
Thomas Lenarz ◽  
Ersin Avci ◽  
Dzemal Gazibegovic ◽  
Rolf Salcher
Keyword(s):  
Lateral Wall ◽  
Temporal Bones

scholarly journals Cone beam CT for perioperative imaging in hearing preservation Cochlear implantation – a human cadaveric study

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kayvan Nateghifard ◽  
David Low ◽  
Lola Awofala ◽  
Dilakshan Srikanthan ◽  
Jafri Kuthubutheen ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cochlear Implantation ◽  
Lateral Wall ◽  
Cone Beam ◽  
Insertion Depth ◽  
Cochlear Duct ◽  
Low Radiation Dose ◽  
A Value ◽  
Cochlear Duct Length ◽  
Temporal Bones

Abstract Background Knowledge of the cochlear implant array’s precise position is important because of the correlation between electrode position and speech understanding. Several groups have provided recent image processing evidence to determine scalar translocation, angular insertion depth, and cochlear duct length (CDL); all of which are being used for patient-specific programming. Cone beam computed tomography (CBCT) is increasingly used in otology due to its superior resolution and low radiation dose. Our objectives are as followed: Validate CBCT by measuring cochlear metrics, including basal turn diameter (A-value) and lateral wall cochlear duct length at different angular intervals and comparing it against microcomputed CT (uCT).Explore the relationship between measured lateral wall cochlear duct length at different angular intervals and insertion depth among 3 different length electrodes using CBCT. Methods The study was performed using fixed human cadaveric temporal bones in a tertiary academic centre. Ten temporal bones were subjected to the standard facial recess approach for cochlear implantation and imaged by CBCT followed by uCT. Measurements were performed on a three-dimensional reconstructed model of the cochlea. Sequential insertion of 3 electrodes (Med-El Flex24, 28 and Soft) was then performed in 5 bones and reimaged by CBCT. Statistical analysis was performed using Pearson’s correlation. Results There was good agreement between CBCT and uCT for cochlear metrics, validating the precision of CBCT against the current gold standard uCT in imaging. The A-value recorded by both modalities showed a high degree of linear correlation and did not differ by more than 0.23 mm in absolute values. For the measurement of lateral wall CDL at various points along the cochlea, there was a good correlation between both modalities at 360 deg and 720 deg (r = 0.85, p < 0.01 and r = 0.79, p < 0.01). The Flex24 electrode displayed consistent insertion depth across different bones. Conclusions CBCT reliably performs cochlear metrics and measures electrode insertion depth. The low radiation dose, fast acquisition time, diminished metallic artifacts and portability of CBCT make it a valid option for imaging in cochlear implant surgery.

Evaluation of a new slim lateral wall electrode for cochlear implantation: an imaging study in human temporal bones

2018 ◽  
Vol 275 (7) ◽  
pp. 1723-1729 ◽  
Author(s):  
Aarno Dietz ◽  
Matti Iso-Mustajärvi ◽  
Sini Sipari ◽  
Jyrki Tervaniemi ◽  
Dzemal Gazibegovic
Keyword(s):  
Cochlear Implantation ◽  
Imaging Study ◽  
Lateral Wall ◽  
Temporal Bones

Anatomic Considerations of the Medial Cuts in the Subtotal Temporal Bone Resection

1982 ◽  
Vol 90 (5) ◽  
pp. 641-645 ◽  
Author(s):  
J. Gail Neely ◽  
Michael Forrester
Keyword(s):  
Temporal Bone ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Lateral Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bone Resection ◽  
En Bloc ◽  
Temporal Bone Resection ◽  
Temporal Bones

Eighteen temporal bones, 20 sets of polytomograms, and two sets of histologically sectioned temporal bones were studied and the literature was reviewed in order to describe the evolution and anatomic detail of the medial limits of the subtotal temporal bone resection used when malignant neoplasia has invaded the middle ear. An en bloc resection requires incisions medial to the pneumatized spaces involved. The anatomy of the lines of resection through the glenoid fossa, medial to the lateral wall of the carotid canal, through the cochlea, internal auditory canal, and jugular bulb, and just lateral to cranial nerves IX, X, and XI was described in detail. Regardless of the techniques employed, or the feasibility of the task, the concept of en bloc resection must conform to the anatomy of the region.

scholarly journals Robot-Assisted Electrode Array Insertion Becomes Available in Pediatric Cochlear Implant Recipients: First Report and an Intra-Individual Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Huan Jia ◽  
Jinxi Pan ◽  
Wenxi Gu ◽  
Haoyue Tan ◽  
Ying Chen ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Electrode Array ◽  
Pure Tone Audiometry ◽  
Lateral Wall ◽  
Robot Assisted ◽  
Insertion Depth ◽  
Safety And Reliability ◽  
Radiological Measurements ◽  
Auditory Performance ◽  
Temporal Bones

Background: As an advanced surgical technique to reduce trauma to the inner ear, robot-assisted electrode array (EA) insertion has been applied in adult cochlear implantation (CI) and was approved as a safe surgical procedure that could result in better outcomes. As the mastoid and temporal bones are generally smaller in children, which would increase the difficulty for robot-assisted manipulation, the clinical application of these systems for CI in children has not been reported. Given that the pediatric candidate is the main population, we aim to investigate the safety and reliability of robot-assisted techniques in pediatric cochlear implantation.Methods: Retrospective cohort study at a referral center in Shanghai including all patients of simultaneous bilateral CI with robotic assistance on one side (RobOtol® system, Collin ORL, Bagneux, France), and manual insertion on the other (same brand of EA and CI in both side), from December 2019 to June 2020. The surgical outcomes, radiological measurements (EA positioning, EA insertion depth, mastoidectomy size), and audiological outcomes (Behavior pure-tone audiometry) were evaluated.Results: Five infants (17.8 ± 13.5 months, ranging from 10 to 42 months) and an adult (39 years old) were enrolled in this study. Both perimodiolar and lateral wall EAs were included. The robot-assisted EA insertion was successfully performed in all cases, although the surgical zone in infants was about half the size in adults, and no difference was observed in mastoidectomy size between robot-assisted and manual insertion sides (p = 0.219). The insertion depths of EA with two techniques were similar (P = 0.583). The robot-assisted technique showed no scalar deviation, but scalar deviation occurred for one manually inserted pre-curved EA (16%). Early auditory performance was similar to both techniques.Conclusion: Robot-assisted technique for EA insertion is approved to be used safely and reliably in children, which is possible and potential for better scalar positioning and might improve long-term auditory outcome. Standard mastoidectomy size was enough for robot-assisted technique. This first study marks the arrival of the era of robotic CI for all ages.

scholarly journals Definition of Metrics to Evaluate Cochlear Array Insertion Forces Performed with Forceps, Insertion Tool, or Motorized Tool in Temporal Bone Specimens

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yann Nguyen ◽  
Guillaume Kazmitcheff ◽  
Daniele De Seta ◽  
Mathieu Miroir ◽  
Evelyne Ferrary ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Electrode Array ◽  
Random Order ◽  
Lateral Wall ◽  
Force Sensor ◽  
Insertion Force ◽  
Minimal Trauma ◽  
Force Profile ◽  
Definition Of ◽  
Temporal Bones

Introduction. In order to achieve a minimal trauma to the inner ear structures during array insertion, it would be suitable to control insertion forces. The aim of this work was to compare the insertion forces of an array insertion into anatomical specimens with three different insertion techniques: with forceps, with a commercial tool, and with a motorized tool.Materials and Methods. Temporal bones have been mounted on a 6-axis force sensor to record insertion forces. Each temporal bone has been inserted, with a lateral wall electrode array, in random order, with each of the 3 techniques.Results. Forceps manual and commercial tool insertions generated multiple jerks during whole length insertion related to fits and starts. On the contrary, insertion force with the motorized tool only rose at the end of the insertion. Overall force momentum was 1.16 ± 0.505 N (mean ± SD,n=10), 1.337 ± 0.408 N (n=8), and 1.573 ± 0.764 N (n=8) for manual insertion with forceps and commercial and motorized tools, respectively.Conclusion. Considering force momentum, no difference between the three techniques was observed. Nevertheless, a more predictable force profile could be observed with the motorized tool with a smoother rise of insertion forces.

NA,K-Atpase in the Cochlear Lateral Wall of Human Temporal Bones with Endolymphatic Hydrops

1995 ◽  
Vol 104 (11) ◽  
pp. 858-863 ◽  
Author(s):  
Elizabeth M. Keithley ◽  
Steve Horowitz ◽  
Michael J. Ruckenstein
Keyword(s):  
Stria Vascularis ◽  
Experimental Studies ◽  
Lateral Wall ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease ◽  
Temporal Bones

Meniere's disease has traditionally been thought to arise from a disruption in longitudinal endolymphatic flow. This view has been brought into question by recent experimental studies that have focused attention on derangements of cochlear fluid and electrolyte homeostatic mechanisms in Meniere's disease, including abnormalities in Na,K-ATPase enzymes found in the cochlear lateral wall. The current study examined the immunohistochemical labeling pattern of the major ion-transporting enzyme of the stria vascularis, Na,K-ATPase, in archival sections of hydropic and nonhydropic human temporal bones for increased density of label that could indicate overproduction of fluid. The results showed good labeling of the stria vascularis in the celloidin sections. The hydropic ears tended to have darker label, but the difference was not statistically significant. The findings are consistent with normal functioning of the stria vascularis in cases of Meniere's disease.

Shrapnell’s membrane in a mammal exposed to extreme pressure variations: morphological and radiological observations in the hooded seal

2003 ◽  
Vol 117 (10) ◽  
pp. 756-762
Author(s):  
Lars-Eric Stenfors ◽  
Helga-Marie Bye ◽  
Tapani Tikkakoski
Keyword(s):  
Middle Ear ◽  
Lateral Wall ◽  
Main Function ◽  
Extreme Pressure ◽  
Thin Sections ◽  
Hooded Seal ◽  
Pressure Equalization ◽  
Pars Tensa ◽  
Ear Ossicles ◽  
Temporal Bones

The function of Shrapnell’s membrane (pars flaccida; PF) in middle-ear mechanics is still an enigma, though numerous proposals have been put forward, e.g. protection of pars tensa, equalizing of middle-ear pressure, sound transmission, and the site of origin of otitis media. In this study the PF was studied in a mammal (the hooded seal) which exposes itself to extreme pressure differences (from 1 to 100 atmospheres) when diving.Formaldehyde-fixed temporal bones obtained from newborn, one-year-old, and adult seals (three of each) were cleansed and decalcified in 10 per cent EDTA. The lateral wall of the middle-ear cavity, including the whole tympanic membrane with its bony surroundings, was then excised and photodocumented. Thin sections were cut parallel with, and perpendicular to, the handle of the malleus, stained with haematoxylin-eosin, toluidine blue or Giemsa stain and examined under a light microscope. One seal head was subjected to high resolution computerized tomography (HRCT) before sectioning. The PF was observed to be a narrow fissure measuring a maximum of 0.8 mm between processus brevis of the malleus and the notch of Rivinus in pars squamosa (pars tensa diameter 10–12 mm). It seems unlikely that the PF of the hooded seal participates in pressure equalization in the middle ear. The main function of the lateral wall of the attic, including the minimal PF, appears to be to protect the middle-ear ossicles and allow movement of the malleus.

Goblet Cell Population in the Normal Middle Ear and Eustachian Tube of Children and Adults

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 44-50 ◽  
Author(s):  
Mirko Tos ◽  
K. Bak-Pedersen
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Round Window ◽  
Newborn Infants ◽  
Lateral Wall ◽  
Goblet Cells ◽  
Oval Window ◽  
Mastoid Process ◽  
Temporal Bones ◽  
Age Range

On 54 temporal bones from entirely normal prematures and newborn infants, children, and adults, 30,000 to 90,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. In the Eustachian tube, normal prematures showed a very low density of goblet cells in all localities, increasing in the pharyngeal parts gradually through childhood and reaching in the normal adult a very high density in the pharyngeal orifice. There are no differences in density between the medial and lateral wall, but in some parts a decrease of density towards the tubal roof. In the middle ear the density is low in normal prematures, increasing slightly in infants, and decreasing again during the age range 7–14 years and in adults. Goblet cells are present in all middle-ear localities, but in markedly decreasing density in this sequence: hypotympanum anteriorly, posteriorly, promontory anteriorly, in the middle, epitympanum, niche of oval window, antrum, niche of round window, mastoid process, incus, and promontory posteriorly.

scholarly journals Value of computed tomography in the preoperative evaluation to identify anatomical abnormalities of the middle ear in children with cholesteatoma: clinical case of lateral position of the sigmoid sinus

2020 ◽  
Vol 24 (4) ◽  
pp. 102-107
Author(s):  
G. V. Vlasova ◽  
P. V. Pavlov ◽  
V. K. Avdeev
Keyword(s):  
Middle Ear ◽  
Surgical Approach ◽  
Clinical Observation ◽  
Preoperative Evaluation ◽  
Lateral Wall ◽  
Lateral Position ◽  
Sigmoid Sinus ◽  
Risk Of Injury ◽  
Middle Ear Disease ◽  
Temporal Bones

The lateral position of the sigmoid sinus is a significant indentation of its sulcus into the lateral wall of the skull, the sigmoid sinus is located lateral to the antrum. This anomaly is rare, occurs in 5–10%. Computerized tomography of temporal bones is performed for all patients with chronic middle ear disease. CT of the temporal bones visualizes in detail the anatomy of the temporal bone. Preoperative diagnosis of lateral position of the sigmoid sinus is very important and determines the choice of a surgical approach to the middle ear during surgery. Clinical observation of a child (14 years) with cholesteatoma of the middle ear is presented in this article. CT tomograms visualized lateral position of the sigmoid sinus. However, the lateral position of the sigmoid sinus was not taken into account when choosing the surgical approach. A transcortical approach to the middle ear was chosen in this clinical observation. Therefore, there was the inevitable and unreasonable denudation of the sigmoid sinus, the difficulty in performing an operation due to the risk of injury. In the reoperation, surgical approach to the middle ear was performed through the tympanic cavity. This avoided dangerous contact with the sigmoid sinus and effectively remove cholesteatoma.

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