Fixation of the Electrode Array with Bone Paté in Cochlear Implant Surgery

Abstract

The aims of this study are to report on our experiences using a bone paté (a mixture of bone dust and fibrin glue) fixation technique of the Combi 40/Combi 40+ electrode array during cochlear implant surgery. A retrospective study involving 57 patients implanted with Combi 40/Combi 40+ cochlear implants over 31 months fixated with bone paté was performed, utilizing our electrical fitting data as well as re-operation and X-ray findings. We found no signs of electrode retraction in any of the 57 patients. Electrical fitting data showed no reduction in the number of active channels between the first and last times patients were evaluated (a period of 4-31 months). Furthermore, a comparison of X-rays performed within the first week following cochlear implant surgery and again 7-27 months later showed no signs of electrode retraction in 10 patients. Three patients who required re-operations after implantation allowed us the opportunity to examine the effectiveness of the bone paté fixation and revealed new bone growth with the electrode fixed in place. Histological examinations of the newly built bone showed laminar and compact bone structures. The use of bone paté was thus found to be a suitable method of electrode fixation in cochlear implant surgery. Compared with other fixation methods, it is inexpensive and uses no foreign materials.

Surgical implications of perimodiolar cochlear implant electrode design: avoiding intracochlear damage and scala vestibuli insertion

“…Some form of cement to secure the cable may be suitable at that site. Osteogenesis may be facilitated by the application of a small amount of bone dust paté to cover the electrode at the facial recess level (Gstoettner et al, 2000;M Dahm, personal communication) Inadvertent displacement of the electrode array after removal of the stylet is a potentially difficult problem. The electrode in its pre-curved position cannot be reinserted without being held straight by the stylet.…”

Conservation of hearing and protection of hair cells in cochlear implant patients' with residual hearing

“…There are no studies that clearly demonstrate the impact of intrascalar bone dust on residual hearing preservation after cochlear implantation; however, elevation of thresholds can occur if there is significant growth of fibrous tissue or bone in the scala tympani that impedes vibration of the basilar membrane (Clark et al, 1995). Bone particles that remain in the mastoid cavity can initiate growth of solid bone over time (Gstöettner et al, 2000). Thus, bone dust that is displaced into the scala tympani during cochlear implantation can promote intracochlear osteoneogenesis, which can potentially affect preservation of residual hearing.…”

Radical Cavities and Cochlear Implantation

“…A one-step surgical procedure is performed, in the following order: post-aural incision (8), subtotal pertosectomy (9), obliteration of the Eustachian tube opening, blind sac closure of the external auditory canal, cochleostomy, insertion and xation of the cochlear implant electrode using muscle aps at cochleostomy and bone pate at the posterior wall of the mastoid cavity (10). The radical cavity is then lled with abdominal fat and covered with the temporal muscle ap.…”