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Cochlear Implant Insertion Axis Into the Basal Turn: A Critical Factor in Electrode Array Translocation.

Renato Torres1,2, Mylène Drouillard1,2, Daniele De Seta1,2

  • 1Sorbonne Universités, Université Pierre et Marie Curie Paris 6, Inserm, Unité "Réhabilitation chirurgicale mini-invasive et robotisée de l'audition".

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|December 2, 2017
PubMed
Summary

An incorrect cochlear implant (CI) insertion angle can cause intracochlear trauma. This study found the angle of approach to the scala tympani centerline is critical for preventing such trauma during CI surgery.

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Area of Science:

  • Otorhinolaryngology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Inappropriate cochlear implant (CI) insertion can lead to intracochlear trauma.
  • Limited research exists on the relationship between CI insertion angle and electrode placement within cochlear scalae.

Purpose of the Study:

  • To investigate the impact of insertion axis on electrode position and intracochlear trauma.
  • To evaluate the efficacy of 3D models in assessing CI array placement and trauma.

Main Methods:

  • Preoperative cone-beam CT (CBCT) scans of 12 human temporal bones.
  • Planned optimal and inaccurate (15-degree deviation) insertion axes for CI electrode arrays.
  • Automated CI insertion using a navigated robot-arm, followed by 3D model reconstruction and microscopic analysis.

Main Results:

  • 3D models showed good agreement with microscopic analysis for electrode positioning (Cohen's kappa = 0.67).
  • A significant correlation was found between the angle of approach to the scala tympani (ST) centerline and the number of electrodes within the ST (r = -0.65, p = 0.02).

Conclusions:

  • 3D reconstruction models are effective for determining CI array position within cochlear scalae.
  • The angle of approach to the ST centerline is a critical factor influencing intracochlear trauma during CI.
  • Further research is needed to explore the insertion axis's impact on different CI electrode designs.