The position of the implant and the MRI sequence used determine the assessment of the IAC and the labyrinth at 3 T MRI. A position of the implant magnet at a nasion-external auditory canal angle which is more horizontal and posterior than so far commonly used allows a better visualization of the IAC and the labyrinth at 3 T.

Introduction. To preserve residual hearing the atraumaticity of the cochlea electrode insertion has become a focus of cochlear implant research. In addition to other factors, the speed of insertion is thought to be a contributing factor in the concept of atraumatic implantation. The aim of our study was to observe intracochlear fluid pressure changes due to different insertional speeds of an implant electrode in a cochlear model. Materials and Methods. The experiments were performed using an artificial cochlear model. A linear actuator was mounted on an Advanced Bionics IJ insertional tool. The intracochlear fluid pressure was recorded through a pressure sensor which was placed in the helicotrema area. Defined insertions were randomly performed with speeds of 0.1 mm/sec, 0.25 mm/sec, 0.5 mm/sec, 1 mm/sec, and 2 mm/sec. Results. A direct correlation between speed and pressure was observed. Mean maximum values of intracochlear fluid pressure varied between 0.41 mm Hg and 1.27 mm Hg. Conclusion. We provide the first results of fluid pressure changes due to insertional speeds of CI electrodes in a cochlear model. A relationship between the insertional speed and intracochlear fluid pressure was observed. Further experiments are needed to apply these results to the in vivo situation.

The evaluation of specific intraoperative electrophysiologic data allowed separating between a regular and an irregular (i.e., scalar changing) position of CI electrodes. This noninvasive methodology can support the postoperative radiologic evaluation of the CI electrode array position.

The number of CI recipients undergoing MRI scans is high. Possible complications and preventive measures attract too little attention in radiological daily routine.

3.0 T MRI scanning can be performed on cochlear implant recipients with a rotatable diametrically magnetized internal magnet without risk of the most frequent cochlear-implant-related MRI complication: pain. This finding enables the expansion of MRI scanning indications up to 3.0 T without complication. Limitations in terms of MRI artifact still persist.

Evidenced by a blinded group of patients, we are able to show that the electrode array position within the cochlea could be predicted using the NRT ratio.

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.

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 CO2 laser 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.