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Cochlear electrode array tip fold-over in incomplete partition-I - A case report.

Luluh Alsughayer¹, Yazeed Al-Shawi², Medhat Yousef³

¹College of Medicine, King Saud University, Riyadh, Saudi Arabia.

International Journal of Pediatric Otorhinolaryngology

|October 28, 2020

Summary

Electrode tip fold-over during cochlear implantation (CI) is rare, particularly with lateral wall (LW) electrodes. This case highlights Stenvers X-ray

Keywords:

Cochlear implantation Ear malformation Implanted electrodes Reoperation Sensorineural hearing loss Tip fold-over

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Area of Science:

Otorhinolaryngology
Neurosurgery
Medical Imaging

Background:

Cochlear implantation (CI) is a surgical intervention for severe to profound hearing loss.
Electrode tip fold-over is a rare but serious complication, particularly with lateral wall (LW) electrodes.
Incomplete partition type-1 (IP-I) is a complex inner ear malformation.

Observation:

A case of LW electrode tip fold-over in a patient with IP-I is presented.
Preoperative cochlear length measurement is crucial for appropriate CI electrode selection.
Stenvers X-ray demonstrated superiority over spread of excitation in identifying tip fold-over in cochlear malformations.

Findings:

Despite the electrode tip fold-over, the patient exhibited nearly symmetrical hearing thresholds, speech reception thresholds, and word recognition scores bilaterally.
The complication did not significantly impact audiological outcomes in this specific case.

Implications:

Revision surgery for electrode tip fold-over should be reserved for cases with persistent symptoms or significant speech performance deficits unresponsive to conservative management.
Accurate preoperative imaging, such as Stenvers X-ray, is vital for managing CI in patients with cochlear malformations.
This case contributes to understanding the management of rare CI complications in complex inner ear anatomy.