Electrode Insertion Trauma in Cochlear Implantation

Author:

O'Leary Michael J.1,House William F.2,Fayad Jose3,Linthicum Fred H.3

Affiliation:

1. San Diego, California

2. Newport Beach, California

3. Los Angeles, California

Abstract

Residual hearing conservation may be important in cochlear implantation of children and of adults with disabling tinnitus responsive to extracochlear stimulation. Damage to the neural elements of the cochlea during electrode insertion may have a negative impact on residual hearing conservation. Histologic analysis of eight temporal bones with cochlear implants reveals trauma at essentially two locations: The round window insertion site and along the basal turn of the cochlea. In four of the bones, insertion at the round window resulted in damage to the osseous spiral lamina and the electrode was inserted through the scala media into the scala vestibuli. Evidence of secondary reactive osseous formation was also noted in these bones. This paper relates the surgical anatomy of the round window to histologic findings and microanatomical dissections. Recommendations for implantation surgery include creation of a cochleostomy by removal of the floor of the round window niche and a superior-to-inferior angle of electrode insertion.

Publisher

SAGE Publications

Subject

General Medicine,Otorhinolaryngology

Reference6 articles.

1. A Postoperative Audiometric Evaluation of Cochlear Implant Patients

2. Proctor B. Surgical anatomy of the ear and temporal bone. New York, NY: Thieme, 1989: 159–96.

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