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Robotic Cochlear Implantation for Direct Cochlear Access

Robotic Cochlear Implantation for Direct Cochlear Access

Published on: June 16, 2022

Electrode array positioning after cochlear reimplantation from single manufacturer.

Miriam R Smetak¹, Shanik J Fernando¹, Matthew R O'Malley¹

¹Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN 37232, USA.

Cochlear Implants International

|July 25, 2023

Summary

Revision cochlear implant surgery with the same device did not significantly alter electrode positioning. However, revision surgery may increase the risk of electrode translocation from the scala tympani to the scala vestibuli.

Keywords:

Angular insertion depth Cochlear implant imaging Electrode array positioning Mean modiolar distance Perimodiolar Revision cochlear implant Scalar location Translocation

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Area of Science:

Otolaryngology
Neurosurgery
Biomedical Engineering

Background:

Cochlear implantation is a complex surgical procedure.
Electrode array positioning is critical for device efficacy.
Revision surgery may be necessary due to device complications or suboptimal outcomes.

Purpose of the Study:

To evaluate changes in electrode positioning after revision cochlear implant surgery.
To assess the impact of revision surgery on scalar location, modiolar distance, and angular insertion depth.
To determine if using the same or a different electrode array style during revision affects positioning.

Main Methods:

Retrospective analysis of a cochlear implant database.
Intra-operative CT scans used for initial and revision implantations.
Auto-segmentation techniques applied to calculate electrode array position.

Main Results:

No significant change in modiolar distance or angular insertion depth after revision surgery.
Three cases of electrode translocation from Scala Tympani to Scala Vestibuli occurred after initial implantation.
Five additional translocations were observed after revision surgery, indicating a potential increased risk.

Conclusions:

Revision cochlear implant surgery with the same device does not significantly alter key electrode positioning indicators.
Revision surgery allows for potential correction of initial electrode misplacement.
There is an increased risk of electrode translocation during revision surgery, irrespective of the electrode array style used.