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Related Concept Videos

The Cochlea01:13

The Cochlea

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The cochlea is a coiled structure in the inner ear that contains hair cells—the sensory receptors of the auditory system. Sound waves are transmitted to the cochlea by small bones attached to the eardrum called the ossicles, which vibrate the oval window that leads to the inner ear. This causes fluid in the chambers of the cochlea to move, vibrating the basilar membrane.
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Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

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Same authorSame journal

Estimating Performance Using Tonotopic Measurements of Intracochlear Electrocochleography: Comparison of Lateral Wall and Perimodiolar Arrays.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery·2026
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Simultaneous multielectrode recordings along the human scala tympani: Evidence for level-dependent place coding.

Proceedings of the National Academy of Sciences of the United States of America·2026
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Development of a Novel Algorithm for Tip Fold-Over Detection in Cochlear Implants and Evaluation on Bench and Multiple Clinical Data Bases.

Audiology research·2025
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Button-Battery Ingestion.

The New England journal of medicine·2024
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Predicting Complications in Head and Neck Surgery: Comparing Calculators to Surgeons.

Ear, nose, & throat journal·2024
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Validating an Evoked Potential Platform for Electrocochleography During Cochlear Implantation.

The Laryngoscope·2024

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Robotic Cochlear Implantation for Direct Cochlear Access
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Speech Performance Following Intraoperative Correction of Cochlear Implant Electrode Array Tip Fold-Overs.

Miriam R Smetak1, Matthew A Shew1, Jordan Varghese1

  • 1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|March 7, 2025
PubMed
Summary

Cochlear implant (CI) electrode array tip fold-overs, though concerning, do not negatively impact speech performance when corrected during surgery. Hearing preservation also appears unaffected by intra-operative fold-over correction.

Keywords:
Cochlear implanthearing preservationintra‐cochlear traumaperimodiolar electrode arraysspeech perception outcomestip fold‐over

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Neuroscience

Background:

  • Cochlear implant (CI) electrode array tip fold-overs occur more frequently with perimodiolar arrays.
  • These fold-overs often necessitate device removal and re-insertion, posing a clinical challenge.

Purpose of the Study:

  • To investigate the impact of intra-operative correction of CI electrode array tip fold-overs on audiological and speech performance.
  • To assess the effect of corrected tip fold-overs on hearing preservation in CI recipients.

Main Methods:

  • Retrospective chart review of cochlear implant recipients who received a slim perimodiolar electrode array between 2016 and 2023.
  • Analysis of speech perception (CNC, AzBio scores) and hearing preservation (low-frequency pure tone average) pre- and post-operatively.
  • Comparison of outcomes between patients with and without intra-operatively corrected tip fold-overs.

Main Results:

  • Of 663 implants, 5.3% experienced tip fold-over, which was corrected intra-operatively.
  • No significant differences were observed in 3-month speech recognition scores (CNC, AzBio) between groups with and without fold-overs.
  • Hearing preservation rates showed no statistically significant difference between groups, although a trend favored those without fold-overs.

Conclusions:

  • Intra-operative identification and correction of cochlear implant electrode array tip fold-overs do not appear to adversely affect speech performance.
  • While tip fold-overs are a clinical concern, prompt correction may mitigate negative impacts on CI outcomes.
  • Further research may be warranted to fully elucidate long-term effects on hearing preservation.