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Published on: February 6, 2026
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.
Summary
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.
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.
