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Apical Electrode Placement to Augment Intracochlear Current in Patients With an Ossified Cochlea and Incomplete

Justin Cottrell¹, Emily R Spitzer², David M Landsberger²

¹Division of Otolaryngology-Head and Neck Surgery, Yale Medicine, New Haven, CT.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology

|June 4, 2026

Summary

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A new surgical technique using an apical ground electrode safely improved sound perception and performance in patients with cochlear ossification and incomplete cochlear implant insertion.

Area of Science:

Otolaryngology
Neurosurgery
Biomedical Engineering

Background:

Cochlear ossification presents challenges for standard cochlear implant (CI) electrode insertion.
Incomplete electrode array insertion can limit auditory stimulation and negatively impact CI outcomes.

Purpose of the Study:

To present a novel surgical technique for intracochlear current modulation.
To describe the use of an apical ground electrode in patients with cochlear ossification and incomplete CI insertion.

Main Methods:

The study involved patients with incomplete CI electrode insertion due to cochlear ossification.
A surgical technique was employed involving standard CI insertion plus an extracochlear apical ground electrode.
This enabled current steering through ossified areas towards the cochlear apex.

Keywords:

Apical electrode Cochlear implantation Cochlear ossification Labyrinthitis ossificans

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Main Results:

Apical ground electrode placement was safe and feasible in 3 patients.
The technique augmented sound perception and improved performance after programming adjustments.
This approach facilitated current steering through cochlear ossification.

Conclusions:

Apical ground electrode placement is a viable adjunct for selected patients with ossified cochlea.
This technique can expand the functional stimulation field via intracochlear current modulation.
Improved patient performance may be achieved with this innovative approach.