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Intraoperative Correction of Cochlear Implant Electrode Translocation
William G Morrel1, Nauman F Manzoor1, Benoit M Dawant2
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Audiology & Neuro-Otology
|April 29, 2021
Summary
Scalar translocation of precurved cochlear implant electrodes can be corrected by removal and reinsertion, significantly improving electrode positioning near the modiolus. This technique showed an 83% success rate in a cadaveric model and a successful in vivo case.
Area of Science:
- Otolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Scalar translocation of precurved cochlear implant electrodes negatively impacts hearing outcomes.
- The possibility of correcting electrode translocation to ensure full placement within the scala tympani (ST) was previously unknown.
Purpose of the Study:
- To investigate the feasibility and effectiveness of correcting scalar translocation of precurved cochlear implant electrodes.
- To assess the impact of translocation correction on electrode positioning within the cochlea.
Main Methods:
- Six cadaveric temporal bones underwent CT scanning and segmentation for cochlear anatomy delineation.
- Precurved cochlear implant electrodes were implanted, and translocation was confirmed postoperatively via CT.
- Electrodes were removed and reinserted to assess correction, with measurements of scalar position, angular insertion depth (AID), and M- (perimodiolar distance).
Main Results:
- Correction of scalar translocation was achieved in 5 out of 6 (83%) cadaveric specimens with a single attempt.
- Corrected electrodes showed a significant improvement in perimodiolar positioning (M- reduced by 38%, p = 0.016).
- A successful correction of translocation was also demonstrated in an in vivo case.
Conclusions:
- Scalar translocation of precurved cochlear implant electrodes is correctable through removal and reinsertion.
- This correction method significantly enhances the perimodiolar positioning of cochlear implant electrodes.
- The study demonstrates a high success rate in both cadaveric and in vivo settings for correcting electrode translocation.
