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A novel perfusion-based method for cochlear implant electrode insertion.

Sushrut Kale1, Vanessa M Cervantes1, Mailing R Wu2

  • 1Department of Otolaryngology-Head & Neck Surgery, Columbia University, New York, NY 10032, USA.

Hearing Research
|June 3, 2014
PubMed
Summary
This summary is machine-generated.

A new fluid flow method offers automated cochlear implant insertion, potentially improving hearing restoration outcomes. Further research is needed to address ototoxicity concerns for clinical viability.

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Area of Science:

  • Biomedical Engineering
  • Otolaryngology
  • Regenerative Medicine

Background:

  • Manual cochlear implant (CI) insertion leads to variable surgical outcomes and cochlear trauma.
  • Current CI electrode insertion methods are limited in reach, often only spanning the basal turn of the cochlea.

Purpose of the Study:

  • To develop an automated and standardized CI electrode insertion technique.
  • To achieve more apical insertion of CI electrodes compared to contemporary methods.
  • To minimize intra-cochlear trauma during CI electrode insertion.

Main Methods:

  • A novel method utilizing viscous fluid flow (diluted Sodium Hyaluronate) to guide CI electrode insertion.
  • Creation of a small cochleostomy in the scala vestibuli and opening of the round window membrane.
  • Perfusion of Sodium Hyaluronate to establish unidirectional flow, carrying the electrode array to the cochlear apex in animal models (rats and gerbils).

Main Results:

  • Successful insertion of silicone implants to the cochlear apex in rats and gerbils without observable cochlear trauma via light-microscopic histology.
  • Measurement of compound action potential (CAP) thresholds revealed substantial elevations following Sodium Hyaluronate perfusion, indicating ototoxicity.

Conclusions:

  • The fluid-flow-assisted CI electrode insertion is a promising proof-of-concept for automated and deeper cochlear access.
  • Further development is required to mitigate the observed ototoxicity of Sodium Hyaluronate perfusion before clinical application.