Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T12:29:08.022Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  06 November 2017

P Mittmann*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus Berlin, Germany
A Ernst
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus Berlin, Germany
I Todt
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus Berlin, Germany
*
Address for correspondence: Dr Philipp Mittmann, Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus Berlin, Warener Str. 7, 12683 Berlin, Germany Fax: +49 30 5681 4303 E-mail: [email protected]

Abstract

Background:

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Miranda, PC, Sampaio, AL, Lopes, RA, Ramos Venosa, A, de Oliveira, CA. Hearing preservation in cochlear implant surgery. Int J Otolaryngol 2014;2014:468515 Google Scholar
2 Adunka, O, Unkelbach, MH, Mack, M, Hambek, M, Gstoettner, W, Kiefer, J. Cochlear implantation via the round window membrane minimizes trauma to cochlear structures: a histologically controlled insertion study. Acta Otolaryngol 2004;124:807–12Google Scholar
3 Carlson, ML, Driscoll, CL, Gifford, RH, Service, GJ, Tombers, NM, Hughes-Borst, BJ et al. Implications of minimizing trauma during conventional cochlear implantation. Otol Neurotol 2011;32:962–8Google Scholar
4 Fraysse, B, Macias, AR, Sterkers, O, Burdo, S, Ramsden, R, Deguine, O et al. Residual hearing conservation and electroacoustic stimulation with the Nucleus 24 Contour Advance cochlear implant. Otol Neurotol 2006;27:624–33Google Scholar
5 Sun, CH, Hsu, CJ, Chen, PR, Wu, HP. Residual hearing preservation after cochlear implantation via round window or cochleostomy approach. Laryngoscope 2015;125:1715–19CrossRefGoogle ScholarPubMed
6 Gantz, BJ, Dunn, C, Walker, E, Van Voorst, T, Gogel, S, Hansen, M. Outcomes of adolescents with a short electrode cochlear implant with preserved residual hearing. Otol Neurotol 2016;37:e11825 Google Scholar
7 Gantz, BJ, Turner, CW. Combining acoustic and electrical hearing. Laryngoscope 2003;113:1726–30Google Scholar
8 Gstottner, W, Pok, SM, Peters, S, Kiefer, J, Adunka, O. Cochlear implantation with preservation of residual deep frequency hearing [in German]. HNO 2005;53:784–90Google Scholar
9 Balkany, TJ, Connell, SS, Hodges, AV, Payne, SL, Telischi, FF, Eshraghi, AA et al. Conservation of residual acoustic hearing after cochlear implantation. Otol Neurotol 2006;27:1083–8Google Scholar
10 Aschendorff, A, Kromeier, J, Klenzner, T, Laszig, R. Quality control after insertion of the Nucleus Contour and Contour Advance electrode in adults. Ear Hear 2007;28:75S79S Google Scholar
11 O'Connell, BP, Hunter, JB, Gifford, RH, Rivas, A, Haynes, DS, Noble, JH et al. Electrode location and audiologic performance after cochlear implantation: a comparative study between Nucleus CI422 and CI512 electrode arrays. Otol Neurotol 2016;37:1032–5Google Scholar
12 Roland, JT Jr. A model for cochlear implant electrode insertion and force evaluation: results with a new electrode design and insertion technique. Laryngoscope 2005;115:1325–39Google Scholar
13 Sennaroglu, L, Atay, G, Bajin, MD. A new cochlear implant electrode with a “cork”-type stopper for inner ear malformations. Auris Nasus Larynx 2014;41:331–6Google Scholar
14 Todd, CA, Naghdy, F, Svehla, MJ. Force application during cochlear implant insertion: an analysis for improvement of surgeon technique. IEEE Trans Biomed Eng 2007;54:1247–55CrossRefGoogle ScholarPubMed
15 Ye, Q, Tillein, J, Hartmann, R, Gstoettner, W, Kiefer, J. Application of a corticosteroid (Triamcinolon) protects inner ear function after surgical intervention. Ear Hear 2007;28:361–9Google Scholar
16 Burghard, A, Lenarz, T, Kral, A, Paasche, G. Insertion site and sealing technique affect residual hearing and tissue formation after cochlear implantation. Hear Res 2014;312:21–7Google Scholar
17 Rajan, GP, Kontorinis, G, Kuthubutheen, J. The effects of insertion speed on inner ear function during cochlear implantation: a comparison study. Audiol Neurootol 2013;18:1722 CrossRefGoogle ScholarPubMed
18 Todt, I, Mittmann, P, Ernst, A. Intracochlear fluid pressure changes related to the insertional speed of a CI electrode. Biomed Res Int 2014;2014:507241 CrossRefGoogle Scholar
19 Mittmann, P, Ernst, A, Todt, I. Intracochlear pressure changes due to round window opening: a model experiment. ScientificWorldJournal 2014;2014:341075 Google Scholar
20 Mittmann, P, Ernst, A, Mittmann, M, Todt, I. Optimisation of the round window opening in cochlear implant surgery in wet and dry conditions: impact on intracochlear pressure changes. Eur Arch Otorhinolaryngol 2016;273:3609–13Google Scholar
21 Todt, I, Ernst, A, Mittmann, P. Effects of round window opening size and moisturized electrodes on the intracochlear pressure related to the insertion of a cochlear implant electrode. Audiol Neurotol Extra 2016;6:18 Google Scholar
22 Todt, I, Karimi, D, Luger, J, Ernst, A, Mittmann, P. Postinsertional cable movements of cochlear implant electrodes and their effects on intracochlear pressure. Biomed Res Int 2016;2016:3937196 Google Scholar
23 Todt, I, Ernst, A, Mittmann, P. Effects of different insertion techniques of a cochlear implant electrode on the intracochlear pressure. Audiol Neurootol 2016;21:30–7Google Scholar
24 Todt, I, Mittmann, M, Ernst, A, Mittmann, P. Comparison of the effects of four different cochlear implant electrodes on intra-cochlear pressure in a model. Acta Otolaryngol 2017;137:235–41Google Scholar
25 Mittmann, M, Ernst, A, Mittmann, P, Todt, I. Insertional depth-dependent intracochlear pressure changes in a model of cochlear implantation. Acta Otolaryngol 2017;137:113–18CrossRefGoogle Scholar
26 Paprocki, A, Biskup, B, Kozlowska, K, Kuniszyk, A, Bien, D, Niemczyk, K. The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery. Folia Morphol (Warsz) 2004;63:309–12Google Scholar
27 Olson, ES. Observing middle and inner ear mechanics with novel intracochlear pressure sensors. J Acoust Soc Am 1998;103:3445–63Google Scholar
28 Havenith, S, Lammers, MJ, Tange, RA, Trabalzini, F, della Volpe, A, van der Heijden, GJ et al. Hearing preservation surgery: cochleostomy or round window approach? A systematic review. Otol Neurotol 2013;34:667–74Google Scholar
29 Kontorinis, G, Paasche, G, Lenarz, T, Stover, T. The effect of different lubricants on cochlear implant electrode insertion forces. Otol Neurotol 2011;32:1050–6Google Scholar
30 Ciuman, RR. Communication routes between intracranial spaces and inner ear: function, pathophysiologic importance and relations with inner ear diseases. Am J Otolaryngol 2009;30:193202 CrossRefGoogle ScholarPubMed
31 Park, JJ, Boeven, JJ, Vogel, S, Leonhardt, S, Wit, HP, Westhofen, M. Hydrostatic fluid pressure in the vestibular organ of the guinea pig. Eur Arch Otorhinolaryngol 2012;269:1755–8Google Scholar
32 Laurens-Thalen, EO, Wit, HP, Segenhout, JM, Albers, FW. Direct measurement flow resistance of cochlear aqueduct in guinea pigs. Acta Otolaryngol 2004;124:670–4Google Scholar