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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

Principal procedure involved in transforming the three-dimensional geometric model of the cochlea into a two-dimensional one. A cutting plane, rotated around the central axis (modiolus), provides stepwise visualization of the cross sections. In each cross section, a point on the outer contour (red) and a second one on the inner contour (green) were manually marked. After perpendicular projection onto a common plane, the points in their totality described the geometry of the inner ear in a 2D manner.
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fig6: Principal procedure involved in transforming the three-dimensional geometric model of the cochlea into a two-dimensional one. A cutting plane, rotated around the central axis (modiolus), provides stepwise visualization of the cross sections. In each cross section, a point on the outer contour (red) and a second one on the inner contour (green) were manually marked. After perpendicular projection onto a common plane, the points in their totality described the geometry of the inner ear in a 2D manner.

Mentions: By repeating steps (3) and (4), the spatial dimensions of the helical cochlear lumen were recorded as a 3D point cloud. Finally, these points were projected onto a plane (an orthogonal-distance regression plane) in order to obtain 2D curves describing the inner and outer contours of the cochlea (see Figure 6).


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

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

Principal procedure involved in transforming the three-dimensional geometric model of the cochlea into a two-dimensional one. A cutting plane, rotated around the central axis (modiolus), provides stepwise visualization of the cross sections. In each cross section, a point on the outer contour (red) and a second one on the inner contour (green) were manually marked. After perpendicular projection onto a common plane, the points in their totality described the geometry of the inner ear in a 2D manner.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig6: Principal procedure involved in transforming the three-dimensional geometric model of the cochlea into a two-dimensional one. A cutting plane, rotated around the central axis (modiolus), provides stepwise visualization of the cross sections. In each cross section, a point on the outer contour (red) and a second one on the inner contour (green) were manually marked. After perpendicular projection onto a common plane, the points in their totality described the geometry of the inner ear in a 2D manner.
Mentions: By repeating steps (3) and (4), the spatial dimensions of the helical cochlear lumen were recorded as a 3D point cloud. Finally, these points were projected onto a plane (an orthogonal-distance regression plane) in order to obtain 2D curves describing the inner and outer contours of the cochlea (see Figure 6).

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