Insertion site and sealing technique affect residual hearing and tissue formation after cochlear implantation

Burghard, A; Lenarz, Thomas; Kral, Andrej; Paasche, Gerrit

doi:10.1016/j.heares.2014.02.002

Cited by 50 publications

(32 citation statements)

References 25 publications

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“…ABR thresholds, DPOAE amplitude, and DPOAE thresholds consistently indicated hearing loss in all frequencies immediately after the electrode insertion in the present study. This acute hearing impairment is consistent with the findings of previous studies Lee et al, 2013;Burghard et al, 2014;Malkoc et al, 2014).…”

Section: Methodssupporting

confidence: 93%

Effects of a dexamethasone-releasing implant on cochleae: A functional, morphological and pharmacokinetic study

et al. 2015

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Section: Methodssupporting

confidence: 93%

Effects of a dexamethasone-releasing implant on cochleae: A functional, morphological and pharmacokinetic study

et al. 2015

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“…Although the cause for this delayed hearing loss remains unknown, possible hypothesized etiologies include triggering an inflammatory cascade (10), an immunologic response (11,12), excitotoxicity due to electric stimulation (13), delayed hair cell degeneration and primary afferent neurons and synapses (14) and post-implantation conductive hearing loss (15). In order to understand the cause of delayed hearing loss following cochlear implantation, the current study was undertaken to analyze the archival human temporal bone specimens from patients who had undergone cochlear implantation surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, others have advocated round window cochlear implant electrode insertion since it causes less trauma to the cochlea. (12,17). Li el al.…”

Section: Discussionmentioning

confidence: 99%

Post Hybrid Cochlear Implant Hearing Loss and Endolymphatic Hydrops

Ishiyama

Doherty

Ishiyama

et al. 2016

Otology &Amp; Neurotology

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Objective To evaluate for potential causes of delayed loss of residual hearing that variably occurs with hybrid cochlear implants. Study design Histopathological evaluation of 29 human temporal bone (HTB) with cochlear implant. Setting The Neurotology and House HTB Laboratory of UCLA (House-UCLA). Subjects and methods HTB from cochlear implant patients from the House-UCLA HTB Laboratory (n = 28) and one courtesy of Massachusetts Eye and Ear Infirmary (MEEI). Histopathological analysis to identify the location of cochleostomy, fibrosis and bone formation in the scala vestibuli and tympani, and endolymphatic hydrops. Spiral ganglion neuron counts were obtained. Statistical analysis compared presence of cochleostomy and location with the histopathological findings. Results Seventeen of 29 bones with fibrosis in the scala vestibule (SV) and tympani had evidence of a cochleostomy involving the SV containing the ductus reunions, all of which had hydrops. Ten of eleven bones had no SV fibrosis, and a cochleostomy limited to the scala tympani, of which all had no hydrops. One HTB had moderate SV fibrosis not involving the ductus reuniens, and was without hydrops. One HTB had a SV cochleostomy but the electrode ruptured Reissner’s membrane, and was without hydrops. Cochleostomy was significantly associated with SV fibrosis and hydrops (p<0.01), those without hydrops had no SV atrophy (p<0.01). Round window insertion was associated with no fibrosis and no hydrops. Conclusion We hypothesize that cochleostomies involving scala vestibuli incite fibrosis, compromising the ductus reuniens, causing hydrops which may cause the delayed loss of residual low frequency hearing in cochlear implant.

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“…Less traumatic techniques of electrode insertion such as insertion through round window membrane may decrease the severity of local tissue response (44,45). …”

Section: Discussionmentioning

confidence: 99%

Intracochlear Inflammatory Response to Cochlear Implant Electrodes in Humans

Seyyedi

Nadol

2014

Otology &Amp; Neurotology

154

116

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Hypothesis This study evaluates the types and degree of tissue response adjacent to the electrode of multichannel cochlear implants. Background cochlear implant electrodes have been classified as biocompatible prostheses. Nevertheless, in some reports, electrode extrusion, chronic inflammation and even soft failure of the implant system have been attributed to a tissue response to the electrode. Methods All celloidin embedded temporal bones with multichannel cochlear implants from the temporal bone collection of the Massachusetts Eye and Ear Infirmary were included in the study. A total of 28 temporal bones from 21 subjects were identified and processed for histology. The severity of cellular response including eosinophil and lymphocytic infiltration, giant cell reaction, new bone formation and fibrosis were scored on a scale from 0 to 3 at three 1mm-segments along the electrode: 1- first 1mm at the cochleostomy, last 1mm from the tip of electrode, and midway between these proximal and distal segments. The values were compared using the Wilcoxon test. Results A granulomatous reaction to the electrode was observed in 27 (96.4%) temporal bones. Eosinophil infiltration was observed in 7 (25%) temporal bones, suggesting an allergic reaction. The Inflammatory response to the electrode was significantly greater at the basal turn of cochlea close to the cochleostomy (p< 0.05) than distal to it. Conclusion An Inflammatory response is common after cochlear implantation and it is more robust at the cochleostomy than distal to it, suggesting the role of trauma of insertion as a contributing factor.

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Insertion site and sealing technique affect residual hearing and tissue formation after cochlear implantation

Cited by 50 publications

References 25 publications

Effects of a dexamethasone-releasing implant on cochleae: A functional, morphological and pharmacokinetic study

Effects of a dexamethasone-releasing implant on cochleae: A functional, morphological and pharmacokinetic study

Post Hybrid Cochlear Implant Hearing Loss and Endolymphatic Hydrops

Intracochlear Inflammatory Response to Cochlear Implant Electrodes in Humans

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