Relations Between Scalar Shift and Insertion Depth in Human Cochlear Implantation

Zelener, F; Majdani, Omid; Roemer, Ariane; Lexow, G. Jakob; Giesemann, Anja; Lenarz, Thomas; Warnecke, Athanasia

doi:10.1097/mao.0000000000002460

Cited by 10 publications

(28 citation statements)

References 43 publications

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“…Four out of the six studies comparing speech perception scores between STL and non-STL reported postoperative means (see Table III), and were, therefore, included. 5,20,32,37 These studies evaluated mainly PM arrays, with time of testing ranging between 3 and 18 months. In addition, three types of lists were used; the CNC words, AzBio sentences, or the Freiburger monosyllables (FMS).…”

Section: Data Extractionmentioning

confidence: 99%

Scalar Translocation Comparison Between Lateral Wall and Perimodiolar Cochlear Implant Arrays ‐ A Meta‐Analysis

et al. 2020

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Objectives/Hypothesis: Two types of electrode arrays for cochlear implants (CIs) are distinguished: lateral wall and perimodiolar. Scalar translocation of the array can lead to intracochlear trauma by penetrating from the scala tympani into the scala vestibuli or scala media, potentially negatively affecting hearing performance of CI users. This systematic review compares the lateral wall and perimodiolar arrays with respect to scalar translocation.Study Design: Systematic review. Methods: PubMed, Embase, and Cochrane databases were reviewed for studies published within the last 11 years. No other limitations were set. All studies with original data that evaluated the occurrence of scalar translocation or tip fold-over (TF) with postoperative computed tomography (CT) following primary cochlear implantation in bilateral sensorineuronal hearing loss patients were considered to be eligible. Data were extracted independently by two reviewers.Results: We included 33 studies, of which none were randomized controlled trials. Meta-analysis of five cohort studies comparing scalar translocation between lateral wall and perimodiolar arrays showed that lateral wall arrays have significantly lower translocation rates (7% vs. 43%; pooled odds ratio = 0.12). Translocation was negatively associated with speech perception scores (weighted mean 41% vs. 55%). Tip fold-over of the array was more frequent with perimodiolar arrays (X 2 = 6.8, P < .01).Conclusions: Scalar translocation and tip fold-overs occurred more frequently with perimodiolar arrays than with lateral wall arrays. In addition, translocation of the array negatively affects hearing with the cochlear implant. Therefore, if one aims to minimize clinically relevant intracochlear trauma, lateral wall arrays would be the preferred option for cochlear implantation.

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Section: Data Extractionmentioning

confidence: 99%

Scalar Translocation Comparison Between Lateral Wall and Perimodiolar Cochlear Implant Arrays ‐ A Meta‐Analysis

et al. 2020

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“…The mean insertion force of MSE is less than 10 mN, corresponding to about 10% of the force expected for a normal straight electrode array with a similar insertion depth [ 34 ]. The MSE has a lower probability of dislocation into the scala vestibuli (scalar shift) than lateral or perimodiolar electrode arrays [ 35 , 36 ]. The functional advantages of the mid-scalar position are lower electrical thresholds, higher dynamic ranges and lower channel interaction compared to electrodes that are usually placed more peripherally in the Scala tympani [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

Functional Outcomes and Quality of Life after Cochlear Implantation in Patients with Long-Term Deafness

Óvári

Hühnlein

Nguyen-Dalinger

et al. 2022

JCM

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Background: Hearing-related quality of life (QoL) after cochlear implantation (CI) is as important as audiological performance. We evaluated the functional results and QoL after CI in a heterogeneous patient cohort with emphasis on patients with long-term deafness (>10 years). Methods: Twenty-eight patients (n = 32 implanted ears, within n = 12 long-term deaf ears) implanted with a mid-scala electrode array were included in this retrospective mono-centric cohort study. Speech intelligibility for monosyllables (SIM), speech reception thresholds (SRT50) and QoL with Nijmegen Cochlear Implant Questionnaire (NCIQ) were registered. Correlation of SIM and QoL was analyzed. Results: SIM and SRT50 improved significantly 12 months postoperatively up to 54.8 ± 29.1% and 49.3 ± 9.6 dB SPL, respectively. SIM progressively improved up to 1 year, but some early-deafened, late implanted patients developed speech understanding several years after implantation. The global and all subdomain QoL scores increased significantly up to 12 months postoperatively and we found a correlation of SIM and global QoL score at 12 months postoperatively. Several patients of the “poor performer” (SIM < 40%) group reported high improvement of hearing-related QoL. Conclusions: Cochlear implantation provides a benefit in hearing-related QoL, even in some patients with low postoperative speech intelligibility results. Consequently, hearing-related QoL scores should be routinely used as outcome measure beside standard speech understanding tests, as well. Further studies with a prospective multi-centric design are needed to identify factors influencing post-implantation functional results and QoL in the patient group of long-term deafness.

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“…Although an important concern during array insertion is to decrease intracochlear trauma, previous studies have reported such deleterious events with all types of arrays [Finley et al, 2008;Boyer et al, 2015;Wanna et al, 2015;O'Connell et al, 2016;Dees et al, 2018;Riggs et al, 2019;Zelener et al, 2020;Daoudi et al, 2021;Vittoria et al, 2021]. Intracochlear trauma is associated with both decreased hearing performance in patients and loss of residual hearing in the case of hearing preservation attempts [Wanna et al, 2011].…”

Section: Introductionmentioning

confidence: 99%

Atraumatic Insertion of a Cochlear Implant Pre-Curved Electrode Array by a Robot-Automated Alignment with the Coiling Direction of the Scala Tympani

et al. 2021

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Introduction: Electrode array translocation is an unpredictable event with all types of arrays, even using a teleoperated robot in a clinical scenario. We aimed to compare the intracochlear trauma produced by the HiFocus™ Mid-Scala (MS) electrode array (Advanced Bionics, Valencia, CA, USA) using a teleoperated robot, with an automated robot connected to a navigation system to align the pre-curved tip of the electrode array with the coiling direction of the scala tympani (ST). Methods: Fifteen freshly frozen temporal bones were implanted with the MS array using the RobOtol® (Collin, Bagneux, France). In the first group (n = 10), the robot was teleoperated to insert the electrode array into the basal turn of the ST under stereomicroscopic vision, and then the array was driven by a slow-speed hydraulic insertion technique with an estimated placement of the pre-curved electrode tip. In the second group (n = 5), 3 points were obtained from the preoperative cone-beam computed tomography: the 2 first defining the ST insertion axis of the basal turn and a third one at the center of the ST at 270°. They provided the information to the automated system (RobOtol® connected with a navigation system) to automatically align the electrode array with the ST insertion axis and to aim the pre-curved tip toward the subsequent coiling of the ST. After this, the electrode array was manually advanced. Finally, the cochleae were obtained and fixed in a crystal resin, and the position of each electrode was determined by a micro-grinding technique. Results: In all cases, the electrode array was fully inserted into the cochlea and the depth of insertion was similar using both techniques. With the teleoperated robotic technique, translocations of the array were observed in 7/10 insertions (70%), but neither trauma nor array translocation occurred with automated robotic insertion. Conclusion: We have successfully tested an automated insertion system (robot + navigation) that could accurately align a pre-curved electrode array to the axis of the basal turn of the ST and its subsequent coiling, which reduced intracochlear insertion trauma and translocation.

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Relations Between Scalar Shift and Insertion Depth in Human Cochlear Implantation

Cited by 10 publications

References 43 publications

Scalar Translocation Comparison Between Lateral Wall and Perimodiolar Cochlear Implant Arrays ‐ A Meta‐Analysis

Scalar Translocation Comparison Between Lateral Wall and Perimodiolar Cochlear Implant Arrays ‐ A Meta‐Analysis

Functional Outcomes and Quality of Life after Cochlear Implantation in Patients with Long-Term Deafness

Atraumatic Insertion of a Cochlear Implant Pre-Curved Electrode Array by a Robot-Automated Alignment with the Coiling Direction of the Scala Tympani

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