Extra-Cochlear Insertion in Cochlear Implantation: A Potentially Disastrous Condition

Abstract

The Journal of International Advanced Otology (J Int Adv Otol) is an international, peer reviewed, open access publication that is fully sponsored and owned by the European Academy of Otology and Neurotology and the Politzer Society. The journal is published triannually in April, August, and December and its publication language is English. The scope of the Journal is limited with otology, neurotology, audiology (excluding linguistics) and skull base medicine. The Journal of International Advanced Otology aims to publish manuscripts at the highest clinical and scientific level. J Int Adv Otol publishes original articles in the form of clinical and basic research, review articles, short reports and a limited number of case reports. Controversial patient discussions, communications on emerging technology, and historical issues will also be considered for publication. Target audience of J Int Adv Otol includes physicians and academics who work in the fields of otology, neurotology, audiology and skull base medicine.

Cochlear Implant Electrode Misplacement: A Case Series and Contemporary Review

“…Proper visualization is crucial to confirming accurate electrode placement, obtaining adequate exposure is of immense importance for the surgeon. This is supported by previous studies that have found identification of anatomic landmarks to be of extreme value, even when visualization is made difficult by unexpected factors, such as mucosal edema, fibrosis, ossification, facial nerve dehiscence, or other abnormalities (3,4,6,8,9,11,13,14).…”

“…Difficulties with anatomic visualization have often been noted in cases of CI misplacement. In this series, the most cited technical factor was poor visualization or misidentification of the round window (3,6,8,9,11,13,14). Thus, lack of visualization of the round window may be associated with CI misplacement.…”

“…Misplacement may also be identified intra- operatively in some cases using intraoperative plain films (10). Revision surgery for misplaced electrode arrays typically requires improving exposure to accurately identify key anatomic landmarks for successful placement of the electrode array, which results in auditory perception and potentially improved speech recognition (2,8,11–13).…”

Research Status and Future Development of Cochlear Reimplantation

“…According to a literature review, most studies regarded the following situations as reimplantation: (1) removal of the initial electrodes for various reasons and implantation of a new device on the ipsilateral or contralateral side, which was the most common scenario defined as reimplantation ( Lassig et al, 2005 ); (2) replacement of the failed hybrid CI with short electroacoustic stimulation (EAS) electrodes or full-length electrodes ( Kamat et al, 2011 ; Jayawardena et al, 2012 ; Dunn et al, 2015 ); (3) reinsertion of the initial electrodes into the cochlea in cases of device migration ( Luo et al, 2020 ); (4) reinsertion of the initial electrodes into the cochlea on the operation day or within a few days of the operation due to the electrodes in incorrect insertion places, such as the internal auditory canal, eustachian tube, vestibul. ( Gözen et al, 2019 ); and (5) simultaneous implantation on both sides when patients with unilateral CI accept reimplantation surgery ( Tang et al, 2019 ).…”

Pre- and post-operative imaging of cochlear implants: a pictorial review

“…Extracochlear electrode array placements like placement in the canal of the internal carotid artery or the Eustachian tube have been very rarely reported in the literature [ 49 , 72 ].…”