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Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Retrograde cochlear implantation in postmeningitic basal turn ossification
Pascal Senn1, Claudio Rostetter, Andreas Arnold
1University Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern, Switzerland. pascal.senn@insel.ch
The Laryngoscope
|June 1, 2012
Summary
Retrograde cochlear implantation offers a safe alternative for postmeningitic basal turn ossification. This method achieved open-set speech discrimination in patients, despite intracochlear array direction changes, with CT scans aiding processor fitting.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Imaging
Background:
- Basal turn ossification post-meningitis complicates cochlear implantation.
- Advanced drill-out techniques are complex.
- A simpler retrograde approach is investigated.
Purpose of the Study:
- To evaluate the clinical and experimental efficacy of retrograde cochlear implantation.
- To assess imaging of intracochlear array morphology.
- To compare outcomes with standard basal turn implantation.
Main Methods:
- Retrospective case-control study of 8 retrograde vs. 17 standard implants.
- Long-term assessment of hearing performance and radiological findings.
- Experimental insertions in 3 human temporal bones using microtomography and histology.
Main Results:
- No complications in the retrograde group.
- Average monosyllabic word scores: 41% (retrograde) vs. 67% (control).
- Radiology showed apical/middle turn insertion and frequent array direction changes; experimental insertions were folding-free.
Conclusions:
- Retrograde cochlear implantation is safe and effective for basal turn ossification.
- Open-set speech discrimination was achieved despite array changes.
- Postoperative CT is recommended for speech processor fitting; experimental work optimized the technique.
