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Individual Optimization of the Insertion of a Preformed Cochlear Implant Electrode Array.

Rau TS, Lenarz T, Majdani O - Int J Otolaryngol (2015)

Bottom Line: Conclusion.This finding leads to the conclusion that, in general, consideration of the specific curling behaviour of a CI electrode array is beneficial in terms of less traumatic insertion.Therefore, these results highlight an entirely novel aspect of clinical application of preformed perimodiolar electrode arrays in general.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

ABSTRACT
Purpose. The aim of this study was to show that individual adjustment of the curling behaviour of a preformed cochlear implant (CI) electrode array to the patient-specific shape of the cochlea can improve the insertion process in terms of reduced risk of insertion trauma. Methods. Geometry and curling behaviour of preformed, commercially available electrode arrays were modelled. Additionally, the anatomy of each small, medium-sized, and large human cochlea was modelled to consider anatomical variations. Finally, using a custom-made simulation tool, three different insertion strategies (conventional Advanced Off-Stylet (AOS) insertion technique, an automated implementation of the AOS technique, and a manually optimized insertion process) were simulated and compared with respect to the risk of insertion-related trauma. The risk of trauma was evaluated using a newly developed "trauma risk" rating scale. Results. Using this simulation-based approach, it was shown that an individually optimized insertion procedure is advantageous compared with the AOS insertion technique. Conclusion. This finding leads to the conclusion that, in general, consideration of the specific curling behaviour of a CI electrode array is beneficial in terms of less traumatic insertion. Therefore, these results highlight an entirely novel aspect of clinical application of preformed perimodiolar electrode arrays in general.

No MeSH data available.


Related in: MedlinePlus

Cochlear implant system for hybrid stimulation. It consists of external (1–3) and internal (implanted) components (4–6). Sounds are captured and digitized by the external sound processor (1, including one or more microphones). Signals and energy are transcutaneously transferred to the implanted portions using an external (2) and an internal (4) coil. These signals are converted by the implant (5) into stimulus-correlated electrical pulses and transmitted to the electrode array (6) implanted into the cochlea (7). In this way, electric stimulation evokes neural responses in the intact auditory nerve. Additionally, low-frequency sound is amplified by the sound processor (1) and transmitted to the normal hearing pathway using an earmould (3) in the external auditory canal (8) (images by courtesy of Cochlear Ltd.).
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fig1: Cochlear implant system for hybrid stimulation. It consists of external (1–3) and internal (implanted) components (4–6). Sounds are captured and digitized by the external sound processor (1, including one or more microphones). Signals and energy are transcutaneously transferred to the implanted portions using an external (2) and an internal (4) coil. These signals are converted by the implant (5) into stimulus-correlated electrical pulses and transmitted to the electrode array (6) implanted into the cochlea (7). In this way, electric stimulation evokes neural responses in the intact auditory nerve. Additionally, low-frequency sound is amplified by the sound processor (1) and transmitted to the normal hearing pathway using an earmould (3) in the external auditory canal (8) (images by courtesy of Cochlear Ltd.).

Mentions: In hearing-impaired patients, the function of the hair cells, which convert acoustic signals into a neural response, is limited or completely absent. The latter case results in deafness. Otherwise, the degree of hearing loss depends on the amount of residual hearing and its usability for communication and environmental sound sensation. However, a useful and well-established surgical procedure—the implantation of an electronic device called a cochlear implant (CI, see Figure 1)—is available to treat deafness and profound to severe hearing loss.


Individual Optimization of the Insertion of a Preformed Cochlear Implant Electrode Array.

Rau TS, Lenarz T, Majdani O - Int J Otolaryngol (2015)

Cochlear implant system for hybrid stimulation. It consists of external (1–3) and internal (implanted) components (4–6). Sounds are captured and digitized by the external sound processor (1, including one or more microphones). Signals and energy are transcutaneously transferred to the implanted portions using an external (2) and an internal (4) coil. These signals are converted by the implant (5) into stimulus-correlated electrical pulses and transmitted to the electrode array (6) implanted into the cochlea (7). In this way, electric stimulation evokes neural responses in the intact auditory nerve. Additionally, low-frequency sound is amplified by the sound processor (1) and transmitted to the normal hearing pathway using an earmould (3) in the external auditory canal (8) (images by courtesy of Cochlear Ltd.).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4581552&req=5

fig1: Cochlear implant system for hybrid stimulation. It consists of external (1–3) and internal (implanted) components (4–6). Sounds are captured and digitized by the external sound processor (1, including one or more microphones). Signals and energy are transcutaneously transferred to the implanted portions using an external (2) and an internal (4) coil. These signals are converted by the implant (5) into stimulus-correlated electrical pulses and transmitted to the electrode array (6) implanted into the cochlea (7). In this way, electric stimulation evokes neural responses in the intact auditory nerve. Additionally, low-frequency sound is amplified by the sound processor (1) and transmitted to the normal hearing pathway using an earmould (3) in the external auditory canal (8) (images by courtesy of Cochlear Ltd.).
Mentions: In hearing-impaired patients, the function of the hair cells, which convert acoustic signals into a neural response, is limited or completely absent. The latter case results in deafness. Otherwise, the degree of hearing loss depends on the amount of residual hearing and its usability for communication and environmental sound sensation. However, a useful and well-established surgical procedure—the implantation of an electronic device called a cochlear implant (CI, see Figure 1)—is available to treat deafness and profound to severe hearing loss.

Bottom Line: Conclusion.This finding leads to the conclusion that, in general, consideration of the specific curling behaviour of a CI electrode array is beneficial in terms of less traumatic insertion.Therefore, these results highlight an entirely novel aspect of clinical application of preformed perimodiolar electrode arrays in general.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.

ABSTRACT
Purpose. The aim of this study was to show that individual adjustment of the curling behaviour of a preformed cochlear implant (CI) electrode array to the patient-specific shape of the cochlea can improve the insertion process in terms of reduced risk of insertion trauma. Methods. Geometry and curling behaviour of preformed, commercially available electrode arrays were modelled. Additionally, the anatomy of each small, medium-sized, and large human cochlea was modelled to consider anatomical variations. Finally, using a custom-made simulation tool, three different insertion strategies (conventional Advanced Off-Stylet (AOS) insertion technique, an automated implementation of the AOS technique, and a manually optimized insertion process) were simulated and compared with respect to the risk of insertion-related trauma. The risk of trauma was evaluated using a newly developed "trauma risk" rating scale. Results. Using this simulation-based approach, it was shown that an individually optimized insertion procedure is advantageous compared with the AOS insertion technique. Conclusion. This finding leads to the conclusion that, in general, consideration of the specific curling behaviour of a CI electrode array is beneficial in terms of less traumatic insertion. Therefore, these results highlight an entirely novel aspect of clinical application of preformed perimodiolar electrode arrays in general.

No MeSH data available.


Related in: MedlinePlus