Evaluation of the advance off-stylet insertion technique and the cochlear insertion tool in temporal bones

Area of Science:

• Otorhinolaryngology
• Biomedical Engineering
• Neurosurgery

Background:

• Cochlear implant electrode design and insertion are critical for device efficacy.
• Evaluating microstructural damage during insertion is essential for improving surgical techniques.
• The Contour electrode with Softip presents new design considerations for cochlear implantation.

Purpose of the Study:

• To assess the microstructural damage caused by different insertion techniques of the Contour electrode with Softip.
• To compare the safety and efficacy of conventional versus Advance Off-Stylet insertion methods.
• To evaluate the reliability of electrode array placement within the cochlea.

Main Methods:

• Utilized microgrinding of 25 fresh frozen human temporal bones.
• Compared three insertion techniques: conventional, manual Advance Off-Stylet, and tool-assisted Advance Off-Stylet.
• Examined two Contour electrode with Softip variants (Softip I and Softip II) across different insertion arms.

Main Results:

• Conventional insertion with Softip I electrodes showed basilar membrane perforations.
• Tool-assisted insertion resulted in good placement but also perforations.
• Advance Off-Stylet technique demonstrated no basilar membrane perforations and reliable perimodiolar placement for both Softip I and II electrodes.

Conclusions:

• The Advance Off-Stylet insertion technique offers a more atraumatic approach for Contour electrode insertion.
• This technique ensures reliable perimodiolar placement of cochlear implant electrodes.
• Microgrinding is an effective method for evaluating cochlear microstructural damage post-insertion.