Faculty Opinions recommendation of Audiologic outcomes of cochlear implantation in cochlear malformations: A comparative analysis of lateral wall and perimodiolar electrode arrays.

Migration of a cochlear implant electrode is a hitherto uncommon complication. So far, array migration has only been observed in lateral wall electrodes. Between 1999 and 2014, a total of 27 patients received bilateral perimodiolar electrode arrays at our institution. The insertion depth angle was estimated on the initial postoperative scans and compared with the insertion depth angle of the postoperative scans performed after contralateral cochlear implantation. Seven (25.93%) patients were found to have an electrode array migration of more than 15°. Electrode migration in perimodiolar electrodes seems to be less frequent and to occur to a lower extent than in lateral wall electrodes. Electrode migration was clinically asymptomatic in all cases.

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

Audiology and Neurotology ◽

10.1159/000489599 ◽

2018 ◽

Vol 23 (3) ◽

pp. 181-186 ◽

Cited By ~ 1

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.

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Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000254 ◽

2007 ◽

Vol 122 (3) ◽

pp. 246-252 ◽

Cited By ~ 36

Author(s):

S Berrettini ◽

F Forli ◽

S Passetti

Keyword(s):

Cochlear Implant ◽

Cochlear Implantation ◽

Surgical Techniques ◽

Electrode Array ◽

Lateral Wall ◽

Hearing Preservation ◽

Acoustic Stimulation ◽

Residual Hearing ◽

Electrode Arrays ◽

Electrode Insertion

AbstractThe preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear.We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing.The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.

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Magnetic Steering of Robotically Inserted Lateral-wall Cochlear-implant Electrode Arrays Reduces Forces on the Basilar Membrane In Vitro

Otology & Neurotology ◽

10.1097/mao.0000000000003129 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Cameron M. Hendricks ◽

Matt S. Cavilla ◽

David E. Usevitch ◽

Trevor L. Bruns ◽

Katherine E. Riojas ◽

...

Keyword(s):

Cochlear Implant ◽

Basilar Membrane ◽

Lateral Wall ◽

Electrode Arrays ◽

Magnetic Steering

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

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-019-0388-x ◽

2019 ◽

Vol 48 (1) ◽

Cited By ~ 2

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.

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Electrode design and insertional depth-dependent intra-cochlear pressure changes: a model experiment

The Journal of Laryngology & Otology ◽

10.1017/s0022215117002195 ◽

2017 ◽

Vol 132 (3) ◽

pp. 224-229 ◽

Cited By ~ 3

Author(s):

P Mittmann ◽

A Ernst ◽

I Todt

Keyword(s):

Cochlear Implant ◽

Fluid Pressure ◽

Electrode Array ◽

Lateral Wall ◽

Peak Frequency ◽

Peak Amplitude ◽

Residual Hearing ◽

Electrode Arrays ◽

Pressure Peak ◽

Pressure Changes

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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