Evaluation of an Electrode Prototype for Atraumatic Cochlear Implantation in Hearing Preservation Candidates

Helbig, Silke; Settevendemie, Claudia; Mack, Martin G.; Baumann, Uwe; Helbig, M.; Stöver, Timo

doi:10.1097/mao.0b013e31820e75d9

Cited by 32 publications

(15 citation statements)

References 20 publications

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“…A flattening of the ST was typically observed at this point as well. This condition is likely to result in cochlear damage during implantation (Helbig et al, 2011;Kha and Chen, 2012;Nadol et al, 2001;Richter et al, 2001;Tykocinski et al, 2001;Wardrop et al, 2005a), with rupturing of the basilar membrane at the location about 10-15 mm along the lateral wall of the ST from the RW. Slow insertion of the electrode array might minimize insertion trauma at 180 .…”

Section: Vertical Trajectory and Cochlear Damage During Implantationmentioning

confidence: 99%

“…The placement of the electrodes close to the auditory nerve fibers is of crucial importance for effective electrical stimulation (Holden et al, 2013;Min et al, 2013;Rebscher et al, 2008). The implantation procedure itself may result in damage to the cochlear structures (Helbig et al, 2011;Kha and Chen, 2012;Nadol et al, 2001;Richter et al, 2001;Tykocinski et al, 2001;Wardrop et al, 2005a). Such damage can in some cases lead to loss of spiral ganglion cells (Adunka and Kiefer, 2006;Leake et al, 1999;Roland and Wright, 2006;Simmons, 1967;Staecker et al, 1998), and therefore may negatively interfere with the outcome of cochlear implantation.…”

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confidence: 99%

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Variations in microanatomy of the human cochlea

Avci

Nauwelaers²,

Lenarz

et al. 2014

J of Comparative Neurology

181

194

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The human cochlea shows considerable interindividual variability in size and morphology. In order to develop atraumatic cochlear implant (CI) electrodes, high-precision details of the variability of human anatomy are required. Sixteen human temporal bones were cut around the cochlea in blocks of approximately 3.5 × 3.5 cm. The bones were scanned by using a Skyscan 1173 micro-computed tomography (μCT) device. Mimics software (Materialise, Leuven, Belgium) was used to segment out the scala tympani (ST) from the μCT images. A three-dimensional surface model of the segmented area was generated for each cochlea. Cross-sectional images were taken and analyzed by custom-designed software in MATLAB. Comparison of different STs showed large variability in cross-sectional diameter (CSD), vertical trajectory, and height of the ST. Relative standard deviations of the CSD were between 9 and 15%. Heights measured at the center of the ST exceeded those in the modiolar and lateral regions of the scala. At the lateral region, the height decreased significantly at the beginning of the second turn. In the vertical trajectory, critical anatomic features were observed, such as dips, vertical jumps, and peaks. Rosenthal's canal (RC) extended to between 560 and 650°. We found a correlation between the length of the RC and that of the ST. The ST was segmented and the internal dimensions measured by using μCT. We observed large dimensional variability between different STs. These differences could have considerable implications for approaches to the design of CI arrays, especially in terms of their ability to preserve residual hearing during insertion of the electrode array. J. Comp. Neurol. 522:3245–3261, 2014. © 2014 Wiley Periodicals, Inc.

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Section: Vertical Trajectory and Cochlear Damage During Implantationmentioning

confidence: 99%

mentioning

confidence: 99%

Variations in microanatomy of the human cochlea

Avci

Nauwelaers²,

Lenarz

et al. 2014

J of Comparative Neurology

181

194

View full text Add to dashboard Cite

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“…Insertion trauma may be reduced with optimized surgical approaches and electrode design (1Y5). Reduced cochlear trauma offers the potential for electrical and acoustic hearing in the same ear (6,7). Furthermore, in dysmorphic cochleae, cochlear implant results are inconsistent (8,9), suggesting the possible need for enhanced strategies of electrical stimulation of available auditory afferents in such cases.…”

mentioning

confidence: 97%

Cochlear Coiling Pattern and Orientation Differences in Cochlear Implant Candidates

Martinez-Monedero¹,

Niparko²,

Aygun³

2011

Otology &Amp; Neurotology

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We observed that perspective 3D-volume rendering of the cochlea enables the determination of key features of cochlear morphology and orientation that may escape detection with routine computed tomographic scanning. Infants and young toddler candidates demonstrate greater variability in the dimensions of the cochlear base and in the orientation of the cochlea within the cranium. As evolving surgical techniques and device design enhance the ability of the surgeon to avoid cochlear damage and optimize electrode location, refined morphometric information may assist the surgeon in tailoring strategies of scala tympani implantation.

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“…Also, the range of the angle b was smaller, suggesting that the bottom plane of the cochlea was less variable relative to the median plane of the skull. The previous studies have demonstrated that the implantation of the electrodes in the cochlea was an important cause of trauma and confirmed that injury of the surgery to the ligamentous ligament and basement membrane occurred mostly in the position where the electrodes passed through the bottom of the cochlea at the first week and began to curl (Erixon et al, 2009;Lloyd et al, 2010;Helbig et al, 2011). Accordingly, to investigate the effect of the a angle on electrode implantation, the evaluation of the angle of inclination after the implantation of the electrodes is necessary, specifically the U angle between the plumb line of the midpoint of the round window membrane and the longest straight line of the base ring of the cochlea.…”

Section: Variation In the Size And Orientation Of The Human Cochleamentioning

confidence: 87%

Anatomical Variations of the Human Cochlea Determined from Micro‐CT and High‐Resolution CT Imaging and Reconstruction

Tang

et al. 2018

The Anatomical Record

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Understanding the anatomical variations in the human cochlea is important for cochlear implants. This study examined these variations using a reconstructed fusion model of the skull and temporal bone. The three-dimensional (3D) digital model of the temporal bone was reconstructed from multiple axial micro-computed tomography (CT) scans of temporal bone and high resolution CT of the skull from 15 cadavers. A skull model was reconstructed and merged with the reconstructed temporal bone. The 3D relationship between the cochlea and the skull's mid-sagittal plane was analyzed. The α and β angles of the cochlear autogenous rotation and bottom position, respectively, further subdivided the cochlear spatial orientation. The relationship between the base of the cochlea and the round window was evaluated with the Φ angle. Cochlear size was measured and the relationship was statistically analyzed. Cochlear implant electrode arrays were observed in five cases of right-temporal bone specimens. The α, β, and Φ angles were 46.01 ± 9.65, 56.79 ± 3.58, and 44.41 ± 7.23, respectively. The α angle varied greatly and was negatively correlated to the Φ angle (correlation coefficient = -0.211, P < 0.05). Among the five specimens, the α and Φ angle of the 2R and 4R cochlear specimens was lower and higher than the mean value, respectively. These measurements revealed variations in the size and position of the cochlea. Some of these variations may require surgical adjustments for insertion of electrodes with cochlear implants and present a greater challenge for implantation of cochlear electrode implantation. These data also provide a better understanding of variations in human cochlear anatomy. Anat Rec, 301:1086-1095, 2018. © 2017 Wiley Periodicals, Inc.

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Evaluation of an Electrode Prototype for Atraumatic Cochlear Implantation in Hearing Preservation Candidates

Abstract: The new prototype electrode carrier is suitable for clinical application. It can be handled easily and allows atraumatic 360-degree insertion of all electrode contacts. Therefore, this electrode concept allows good coverage of the cochlea for electrical and additional acoustic stimulation.

Cited by 32 publications

References 20 publications

Variations in microanatomy of the human cochlea

Variations in microanatomy of the human cochlea

Cochlear Coiling Pattern and Orientation Differences in Cochlear Implant Candidates

Anatomical Variations of the Human Cochlea Determined from Micro‐CT and High‐Resolution CT Imaging and Reconstruction

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