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Updated: Dec 8, 2025
Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
Transimpedance Matrix (TIM) Measurement for the Detection of Intraoperative Electrode Tip Foldover Using the Slim
Tim M Klabbers1,2, Wendy J Huinck1,2, Floris Heutink1,2
1Department of Otorhinolaryngology and Head and Neck Surgery, Radboud university medical center, Nijmegen, The Netherlands.
Objectives:
The aim of this study is to report on our preliminary experience with Transimpedance Matrix (TIM)-measurement for the detection of cochlear implant electrode tip foldovers compared with intraoperative imaging in patients implanted with the slim modiolar electrode (SME).
Study Design:
Proof of concept study.
Setting:
Tertiary university referral center.
Patients:
Twenty five ears (in 22 patients) implanted consecutively with the SME.
Interventions:
Following cochlear implantation, intraoperative TIM-measurement and fluoroscopy were performed. One week postoperatively, the electrode position was evaluated using Computed Tomography (CT)-imaging.
Main Outcome Measures:
Electrode array tip foldover.
Results:
Electrode array tip foldover occurred in three of the 25 cochlear implantations performed (12%). In each case, the foldover was detected by both TIM and fluoroscopy, leading to reposition and correct intracochlear placement of the array.
Conclusions:
TIM-measurement is a promising method for the intraoperative detection of an electrode array tip foldover. The TIM-tool with intuitive heatmap display is easy to use, fast, and readily available to clinics using TIM-software in the operating theatre.
