The Effects of Gusher-Related Intracochlear Pressure Changes on Hearing Preservation in Cochlear Implantation: A Comparative Series

Crohan, William; Krishnaswamy, Jay; Rajan, Gunesh

doi:10.1159/000489599

Cited by 4 publications

(1 citation statement)

References 33 publications

(48 reference statements)

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“…However, even with major advances in soft surgery techniques, 100% hearing preservation remains elusive. With speed (Rajan et al, 2013), CSF gusher (Crohan et al, 2018), and electrode stabilization (Bruce and Todt, 2018) all demonstrating a significant effect on hearing preservation, it is generally accepted that minimizing intracochlear pressure variation has a significant role in structure preservation. Greene et al (2016) made an important contribution to understanding the significance of intracochlear pressure variation by explaining and demonstrating how the two pressure levels (of the external auditory canal and intracochlear pressure levels) were comparable during surgical implantation.…”

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confidence: 99%

The effect of surgeon experience and insertion speed on intracochlear pressures during in-vitro cochlear implantation

Crohan,

Tavora-Vieira,

Voola

et al. 2024

Front. Audiol. Otol.

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HypothesisThat increased insertion speed is associated with increased intracochlear pressure variation.BackgroundPreservation of residual hearing is an important goal of modern cochlear implant surgery. Many factors, including intracochlear pressure changes during insertion, are thought to be significant in the preservation of residual hearing through the reduction in intraoperative trauma to the cochlea.MethodsParticipants at a cochlear implantation hearing preservation workshop open to surgeons and audiologists were invited to participate in a challenge to insert a cochlear implant electrode into an in-vitro model of a cochlea. Intracochlear pressure variation was measured as a surrogate marker for intracochlear trauma against insertion speed, method of insertion, moisturization of the electrode, and participant experience.ResultsThe study demonstrated that the relative experience of a surgeon and the speed of insertion were significant for maximal intracochlear pressure variation. The more experienced participants were likely to demonstrate lower pressure variation, and a slower insertion on average produced significantly smaller pressure changes than faster insertions. No other variables were deemed significant for maximal intracochlear pressure variation.ConclusionSurgeon experience and speed of implant insertions were significant factors in the reduction of intracochlear pressure variation during cochlear implantation simulations

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confidence: 99%