[The non-damaging method for the insertion of a standard electrode for cochlear ossification]

Area of Science:

• Otolaryngology
• Neurosurgery
• Biomedical Engineering

Context:

• Cochlear ossification presents significant challenges for cochlear implant electrode insertion.
• Severe sensorineural hearing impairment necessitates advanced surgical solutions.
• Standard electrode insertion methods can be complicated by ossified cochlear structures.

Purpose:

• To develop a non-damaging surgical technique for standard electrode insertion in ossified cochleae.
• To optimize electrode placement for improved hearing and speech rehabilitation in affected patients.
• To identify the optimal location for cochleostomy to preserve critical cochlear anatomy.

Summary:

• A novel surgical approach was developed and tested on 20 cadaveric temporal bones to understand anatomical relationships and determine optimal electrode insertion.
• The technique involves precise removal of ossified structures and a specifically located cochleostomy to maximize electrode array insertion into the cochlear spiral canal.
• The method was successfully applied to 11 patients with significant cochlear ossification, enabling maximum electrode insertion.

Impact:

• Successful implementation in 11 patients with Grade IV sensorineural hearing loss and >5mm basal cochlear ossification.
• Achieved excellent hearing and speech rehabilitation results in patients with ossified cochleae.
• Provides a viable surgical solution for a challenging patient population undergoing cochlear implantation.