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A systematic review of electrode array scalar dislocation after cochlear implant surgery.

Huajie Bu1, Eva Maria Fritz1, Patrick F Connolly1

  • 1MED-EL Elektromedizinische Geräte GmbH, Innsbruck, Austria.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|March 23, 2026
PubMed
Summary

Scalar dislocation (SD) rates after cochlear implant surgery differ significantly by electrode array type and manufacturer. Lateral wall (LW) arrays showed the lowest SD rates, with MED-EL devices demonstrating the best outcomes.

Keywords:
Cochlear implantElectrode arrayHearing preservationScala tympaniStructure preservationSurgery

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Neurosurgery

Background:

  • Scalar dislocation (SD) is a potential complication following cochlear implant surgery.
  • Understanding SD rates associated with different electrode array designs and manufacturers is crucial for optimizing surgical outcomes and patient safety.

Purpose of the Study:

  • To systematically review and quantify the incidence of scalar dislocation (SD) after cochlear implant surgery.
  • To compare SD rates between lateral wall (LW) and pre-formed (PF) electrode array types.
  • To analyze SD rates across three different cochlear implant manufacturers.

Main Methods:

  • Systematic literature search of databases for relevant studies published between August 2014 and December 2023.
  • Quantitative synthesis of data from 66 publications, encompassing 4,729 cochlear implantations.
  • Statistical analysis to compare SD rates based on array type and manufacturer.

Main Results:

  • Overall scalar dislocation (SD) rate was 19.5% (923/4,729 implantations).
  • Lateral wall (LW) arrays had a significantly lower SD rate (8.1%) compared to pre-formed (PF) arrays (25.0%).
  • MED-EL arrays exhibited the lowest SD rate (6.4%), significantly lower than Manufacturer A (23.2%) and Manufacturer B (21.3%) arrays. LW arrays were associated with lower SD rates than PF arrays within Manufacturer A and B.

Conclusions:

  • Cochlear implant electrode array type and manufacturer significantly influence scalar dislocation (SD) rates.
  • Lateral wall (LW) arrays demonstrate a lower incidence of SD compared to pre-formed (PF) arrays.
  • MED-EL cochlear implant arrays show the lowest SD rates among the manufacturers studied.