Comparison of electrode position in the human cochlea using various perimodiolar electrode arrays

Tykocinski, Michael; Cohen, Lawrence T.; Pyman, B. C.; Roland, Thomas; Treaba, Claudiu; Palamara, Joseph E.A.; Dahm, Markus; Shepherd, Robert K.; Xu, Jin; Cowan, Robert; Cohen, Noel L.; Clark, Graeme M.

doi:10.1016/s0196-0709(00)80010-1

Cited by 112 publications

(91 citation statements)

References 13 publications

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“…In recent studies, the extent of cochlear trauma was assessed when implanting a twocomponent electrode array [19,20]. Other concepts of perimodiolar placement of cochlear implant electrodes have been evaluated in human temporal bones, all of which showed an increased rate of cochlear trauma [21][22][23]. For EAS [2][3][4], cochlear trauma is not acceptable.…”

Section: Discussionmentioning

confidence: 99%

Preservation of Basal Inner Ear Structures in Cochlear Implantation

Adunka

Gstœttner

Hambek

et al. 2004

ORL

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The aim of this report was to examine basal trauma in implanted human temporal bones and discuss modified approaches to the basal cochlear turn to avoid destruction of basal cochlear structures. Thirty-three human temporal bones were implanted with four different cochlear implant electrode arrays manufactured by MED-EL using either a caudal approach cochleostomy or round window membrane insertions. All specimens were processed with a special histological technique that allows sectioning of undecalcified bone with the electrode in situ. All bones were evaluated histologically in terms of basal cochlear trauma. Two pathomechanisms of basal trauma could be distinguished and were evaluated separately, buckling of the basal end of the array and trauma by drilling. Using the caudal approach cochleostomy, the total percentage of destructive basal trauma was 48% compared to less than 15% when performing round window membrane insertions. Although it is still unclear whether basal cochlear trauma influences apical cochlear function or not, adapted surgical procedures and no forceful insertion maneuvers should be used when performing cochlear implantations with hearing preservation.

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Section: Discussionmentioning

confidence: 99%

Preservation of Basal Inner Ear Structures in Cochlear Implantation

Adunka

Gstœttner

Hambek

et al. 2004

ORL

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“…Trauma to the delicate structures of the inner ear frequently occurs during insertion of CI electrodes [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. This damage ranges from relatively minor displacement of the basilar membrane to severe fracture of the osseous spiral lamina, tearing of the basilar membrane or spiral ligament, and deviation of the electrode path from its intended location in the ST to the overlying scala media and/or scala vestibuli.…”

Section: Reduced Damagementioning

confidence: 99%

Considerations for design of future cochlear implant electrode arrays: Electrode array stiffness, size,

Rebscher

Hetherington²,

Bonham³

et al. 2008

JRRD

153

121

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Abstract-The level of hearing rehabilitation enjoyed by cochlear implant (CI) recipients has increased dramatically since the introduction of these devices. This improvement is the result of continual development of these systems and the inclusion of subjects with less severe auditory pathology. Developments include advanced signal processing, higher stimulation rates, greater numbers of channels, and more efficient electrode arrays that are less likely to produce insertion damage. New directions in the application of CIs, particularly in combined acoustic and electrical stimulation, and increasing performance expectations will place greater demands on future electrode arrays. Specifically, the next generation of arrays must be reliably inserted without damage, must maintain residual acoustic function, and may need to be inserted more deeply. In this study, we measured the mechanical properties of eight clinical and prototype human CI electrode arrays and evaluated insertion trauma and insertion depth in 79 implanted cadaver temporal bones. We found that the size and shape of the array directly affect the incidence of observed trauma. Further, arrays with greater stiffness in the plane perpendicular to the plane of the cochlear spiral are less likely to cause severe trauma than arrays with similar vertical and horizontal stiffness.

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“…In order to achieve aim 1, a new fixation technique was utilised (as described in the companion article 16 ), which reduces artifactual retinal delamination. In order to achieve aim 2, we modified an embedding, grinding, and polishing technique, originally developed for in situ observation of cochlear implant electrodes [21][22][23] . The methods described in this manuscript allow the visualisation of the retina surrounding and adjacent to a tack in situ while minimizing artifactual retinal damage and therefore allowing accurate assessment of any potential damage caused by the tack and epiretinal array.…”

Section: Introductionmentioning

confidence: 99%

Techniques for Processing Eyes Implanted with a Retinal Prosthesis for Localized Histopathological Analysis: Part 2 Epiretinal Implants with Retinal Tacks

Nayagam

Durmo²,

McGowan

et al. 2015

JoVE

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Retinal prostheses for the treatment of certain forms of blindness are gaining traction in clinical trials around the world with commercial devices currently entering the market. In order to evaluate the safety of these devices, in preclinical studies, reliable techniques are needed. However, the hard metal components utilised in some retinal implants are not compatible with traditional histological processes, particularly in consideration for the delicate nature of the surrounding tissue. Here we describe techniques for assessing the health of the eye directly adjacent to a retinal implant secured epiretinally with a metal tack.Retinal prostheses feature electrode arrays in contact with eye tissue. The most commonly used location for implantation is the epiretinal location (posterior chamber of the eye), where the implant is secured to the retina with a metal tack that penetrates all the layers of the eye. Previous methods have not been able to assess the proximal ocular tissue with the tack in situ, due to the inability of traditional histological techniques to cut metal objects. Consequently, it has been difficult to assess localized damage, if present, caused by tack insertion.Therefore, we developed a technique for visualizing the tissue around a retinal tack and implant. We have modified an established technique, used for processing and visualizing hard bony tissue around a cochlear implant, for the soft delicate tissues of the eye. We orientated and embedded the fixed eye tissue, including the implant and retinal tack, in epoxy resin, to stabilise and protect the structure of the sample. Embedded samples were then ground, polished, stained, and imaged under various magnifications at incremental depths through the sample. This technique allowed the reliable assessment of eye tissue integrity and cytoarchitecture adjacent to the metal tack.

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Comparison of electrode position in the human cochlea using various perimodiolar electrode arrays

Cited by 112 publications

References 13 publications

Preservation of Basal Inner Ear Structures in Cochlear Implantation

Preservation of Basal Inner Ear Structures in Cochlear Implantation

Considerations for design of future cochlear implant electrode arrays: Electrode array stiffness, size,

Techniques for Processing Eyes Implanted with a Retinal Prosthesis for Localized Histopathological Analysis: Part 2 Epiretinal Implants with Retinal Tacks

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