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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

More detailed findings with regard to trauma risk throughout the insertion process for RE07 compared with RE01. The results indicate that where no additional adjustment of the electrode orientation is possible, a straight starting configuration is more advantageous than the slightly curled one.
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Related In: Results  -  Collection


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fig13: More detailed findings with regard to trauma risk throughout the insertion process for RE07 compared with RE01. The results indicate that where no additional adjustment of the electrode orientation is possible, a straight starting configuration is more advantageous than the slightly curled one.

Mentions: Figure 13 provides detailed insight into the changing rating of the trauma risk with progressive insertion depth. For this purpose, the two extreme cases (RE01 and RE07) are plotted together in one figure to show the overall spectrum of the results and its correlation with the curling profile of the electrode array. While the insertion of RE01 is completely in the orange or red zone, the trauma risk using RE07 is at least reduced in the initial phase of insertion. It is striking that RE01 shows very pronounced deflection of the electrode tip from the ideal straight configuration, which means a marked initial curvature (starting configuration). In contrast, the profile for the curling behaviour of RE07 is very flat (see Figure 3). Based on this finding, it is concluded that the good straight starting curvature is causal and thus beneficial in terms of low trauma risk during the initial phase of the insertion process.


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

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

More detailed findings with regard to trauma risk throughout the insertion process for RE07 compared with RE01. The results indicate that where no additional adjustment of the electrode orientation is possible, a straight starting configuration is more advantageous than the slightly curled one.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig13: More detailed findings with regard to trauma risk throughout the insertion process for RE07 compared with RE01. The results indicate that where no additional adjustment of the electrode orientation is possible, a straight starting configuration is more advantageous than the slightly curled one.
Mentions: Figure 13 provides detailed insight into the changing rating of the trauma risk with progressive insertion depth. For this purpose, the two extreme cases (RE01 and RE07) are plotted together in one figure to show the overall spectrum of the results and its correlation with the curling profile of the electrode array. While the insertion of RE01 is completely in the orange or red zone, the trauma risk using RE07 is at least reduced in the initial phase of insertion. It is striking that RE01 shows very pronounced deflection of the electrode tip from the ideal straight configuration, which means a marked initial curvature (starting configuration). In contrast, the profile for the curling behaviour of RE07 is very flat (see Figure 3). Based on this finding, it is concluded that the good straight starting curvature is causal and thus beneficial in terms of low trauma risk during the initial phase of the insertion process.

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