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'Cochlear Implants Surgical Technique' (481)


Jan
2018

In the past few decades, considerable development was achieved in the cochlear implantation following the emergence of innovative electrode array and advances in minimally invasive surgery. Minimally invasive technique led to a better preservation of residual low-frequency hearing. The loss of residual hearing was caused by complicated factors.

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Jan
2018

To investigate the clinical usefulness and practicality of co-registration of Cone Beam CT (CBCT) with preoperative Magnetic Resonance Imaging (MRI) for intracochlear localization of electrodes after cochlear implantation.
Images of 20 adult patients who underwent CBCT after implantation were co-registered with preoperative MRI scans. Time taken for co-registration was recorded.

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Dec
2017

The round window is an important portal for the application of active hearing aids and cochlear implants. The anatomical and topographical knowledge about the round window region is a prerequisite for successful insertion for a cochlear implant electrode.
To sum up current knowledge about the round window anatomy and to give advice to the cochlear implant surgeon for optimal placement of an electrode.

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Mar
2018

Cochlear implantation remains a popular and effective therapy for patients with sensorineural hearing loss that not get benefit from conventional hearing aids Objective: To analyze the surgical complications obtained in patients that underwent cochlear implantation in a tertiary university hospital.
Retrospective analysis of the medical files of cochlear implant patients who underwent surgery at our institution between October 2014 and July 2016. This population comprised 163 patients (52.

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Dec
2017

Endoscope-Assisted Cochlear Implantation.

Clin Exp Otorhinolaryngol 2017 Dec 1. Epub 2017 Dec 1.
Enis Alpin Güneri, Yüksel Olgun
Our aim was to present our endoscope-assisted cochlear implantation (CI) technique, in which the middle ear landmarks were identified through the facial recess exposure by using an endoscopic view without elevating the tympanic annulus. The secondary goal was to assess whether the situation of difficult surgical exposure could be predicted by evaluating preoperative axial computed tomography (CT) examinations.
CT examinations and surgical outcomes of endoscope-assisted CI surgeries were analyzed.

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Nov
2017

To assess differences in intra- and postoperative electrode impedances following cochlear implantation between round window insertions (RWI) and extended round window insertions (ERWI).
Fifty patients with congenital hearing loss received unilateral hearing implants (Sonata Ti100, Med-El GmbH, Innsbruck, Austria) with standard electrode arrays. The patients were divided into two groups according to the surgical technique used.

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Feb
2018

Objective To evaluate cochlear trauma after cochlear implant insertion through a middle fossa approach by means of histologic and imaging studies in temporal bones. Study Design Prospective cadaveric study. Setting University-based temporal bone laboratory.

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Jan
2018

Percutaneous pedestals in cochlear implantation.

Cochlear Implants Int 2018 Jan 16;19(1):54-60. Epub 2017 Oct 16.
Alistair Mitchell-Innes, Richard Irving, Robert Briggs
Percutaneous pedestals have been integral to the development of cochlear implants since 1969. By enabling direct electrical access to implanted electrodes or other devices, they allow optimization of control of stimulation strategies. Similarly, technology not validated for implantable use can be safely tested.

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Nov
2017

Epidermolysis bullosa (EB) is a spectrum of mechanobullous disorders characterized by blistering following minor trauma or traction to the skin. Hearing loss in this population is poorly described in the otolaryngology literature, and its treatment oftentimes results in external auditory canal skin irritation.
We present the case of a 26-year-old female with EB and mixed hearing loss unable to wear conventional hearing aids due to sequelae of the external auditory canals.

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Jul
2017

Utilizing the cochlear implant to record electrophysiologic responses during device placement is a feasible and efficacious technique for monitoring near real-time cochlear physiology during and following electrode insertion.
Minimizing intracochlear trauma during cochlear implantation has emerged as a highly researched area to help improve patient performance. Currently, conventional cochlear implant technology allows for the recording of electrically evoked compound action potentials (eCAPs).

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Dec
1969

Patients with previously implanted cranial devices pose a special challenge in deep brain stimulation (DBS) surgery. We report the implantation of bilateral DBS leads in a patient with a cochlear implant. Technical nuances and long-term interdevice functionality are presented.

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Jul
2017

Cochlear implant (CI)-related wound infections are known to happen even years after the implant procedure and present a challenging clinical situation. Due to the formation of biofilm on the implant surface such infections are difficult to eradicate. Invariably explantation of the device is required for wound healing.

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Jan
2018

Contemporary imaging of auditory implants.

Clin Radiol 2018 Jan 5;73(1):19-34. Epub 2017 Apr 5.
S E J Connor
There have been significant advances in the diversity and effectiveness of hearing technologies in recent years. Implanted auditory devices may be divided into those that stimulate the cochlear hair cells (bone conduction devices and middle ear implants), and those that stimulate the neural structures (cochlear implants and central auditory implants). Contemporary preoperative and postoperative imaging may be used to help individualise implant selection, optimise surgical technique and predict auditory outcome.

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May
2017

Our objective was to prospectively evaluate implementation of a new cochlear implant (CI) mapping technique, image-guided cochlear implant programming (IGCIP), at a site distant to the site of development. IGCIP consists of identifying the geometric relationship between CI electrodes and the modiolus and deactivating electrodes that interfere with neighboring electrodes. IGCIP maps for 17 ears of 15 adult CI patients were developed at a central image-processing center, Vanderbilt, and implemented at a distant tertiary care center, House Ear Institute.

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Jul
2017

Objective Precurved electrode arrays (EAs) are commonly used in cochlear implants (CIs). Modiolar placement of such arrays has been shown to lead to better hearing outcomes. In this project, we retrospectively evaluated the modiolar positioning of EAs within a large CI imaging database.

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Jun
2017

This study aimed to evaluate migration of the receiver-stimulator after cochlear implantation using the subperiosteal pocket technique.
A prospective clinical study was performed of 32 paediatric patients (aged between 12 months and 8 years; mean ± standard deviation, 28 ± 19 months) who underwent cochlear implantation in tertiary referral centres. The degree of migration was evaluated using measurements between the receiver-stimulator and selected reference points: the lateral canthus, tragus and mastoid tip.

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Mar
2017

CBCT allows a precise evaluation of the dimensions and of the shape of the cochlear duct that is of primary importance for the choice of the length and the design of the electrode array. This radio-histological study confirms that CBCT is a reliable tool to be used in clinical studies to evaluate the position of straight electrode arrays within the cochlear scala.
To validate the reliability of cone beam computed tomography (CBCT) in the evaluation of cochlear anatomy and positioning of a straight electrode array, by comparing radiological images to histological analysis of cochlear implanted temporal bones.

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Apr
2017

To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication.
A 3.

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Apr
2017

The objective of the present study: the improvement of the quality and effectiveness of the surgical stage of cochlear implantation on the basis of the comprehensive analysis of performed reoperations.
84 patients of the 2413 ones who had undergone cochlear implantation were re-examined by revision surgery within various periods after the first intervention.
In certain patients, the correction of the intracochlear electrode array position was performed and in 72 cases the replacement of the implant was done.

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Dec
1969

To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement.
Multicentre retrospective, observational survey.

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Jan
2017

To review the difficulties that can occur during cochlear implant surgery in patients with inner ear abnormalities and the management thereof.
A retrospective chart review of 316 patients who received cochlear implants was conducted. The data collected included the types of inner ear anomalies, intraoperative findings, and the clinical management strategies.

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Mar
2017

The microgrinding technique is used to study cochlear implant electrode positioning and cochlear trauma. It may be argued that this technique might cause damage to inner cochlear structures even without a cochlear implant insertion and thus it should not be recommended. Most papers do not explain how microgrinding is performed, referring to older papers for its description.

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Dec
2016

Two pediatric patients with internal device exposure of cochlear implant (CI) were treated successfully using vascularized temporalis myofascial flaps. The visible scarring was minimal, and the CI function was excellent. Although we used temporalis myofascial flaps for late complications of an implanted ear, it can also be used in a primary case to provide flap reinforcement.

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Dec
2016

The aim of the present study was to describe the use of the endoscopic-assisted cochlear implantation in cases with an unsuccessful standard surgical technique because of not achieving adequate exposure to the round window (RW). Three patients with a bilateral profound hearing loss were operated using an endoscopic-assisted cochlear implant procedure at our tertiary university referral center between 2012 and 2014. In all of the patients, a retroauricular "c" shaped incision was performed and a subperiosteal pocket was created.

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Nov
2016

The study objective was to develop quality measures for adult cochlear implant centers. A modified Delphi design beginning with focus groups of surgeons and audiologists was used, as adapted from the American College of Cardiology / American Heart Association method for creating quality measures. Two academic cochlear implant programs and 1 private program participated.

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Dec
1969

Cochlear implant (CI) electrode insertion into the round window induces pressure transients in the cochlear fluid comparable to high-intensity sound transients.
Many patients receiving a CI have some remaining functional hearing at low frequencies; thus, devices and surgical techniques have been developed to use this residual hearing. To maintain functional acoustic hearing, it is important to retain function of any hair cells and auditory nerve fibers innervating the basilar membrane; however, in a subset of patients, residual low-frequency hearing is lost after CI insertion.

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Aug
2016

Due to an increasing number of cochlear implantations, quality control has become more important. In addition to intraoperative biophysical measurements, radiological imaging is another possibility. An upcoming technique regarding this is Cone Beam CT (CBCT).

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Feb
2017

Goals of cochlear implantation have shifted from complete insertion of the cochlear electrode array towards low traumatic insertion with minimally invasive techniques. The aim of this study was first to evaluate, in a guinea pig model of cochlear implantation, the effect of a motorized insertion technique on hearing preservation. The second goal was to study a new gel formulation containing dexamethasone phosphate loaded in liposomes (DEX-P).

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Feb
2017

It has previously reported that alignment of the insertion axis along the basal turn of the cochlea was depending on surgeon' experience. In this experimental study, we assessed technological assistances, such as navigation or a robot-based system, to improve the insertion axis during cochlear implantation. A preoperative cone beam CT and a mastoidectomy with a posterior tympanotomy were performed on four temporal bones.

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Jan
2017

Barriers to early pediatric cochlear implantation in underinsured populations have been previously reported. However, to our knowledge, the effect of this delay on the development of auditory and speech-language objectives has not been evaluated.
To determine if health care insurance status affects the achievement of proficiency in basic sound access and imitation tasks in children with cochlear implants.

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Dec
1969

This study reviewed outcomes of hearing preservation (HP) surgery in a cochlear implant patient population, with clinical follow-up results up to 11 years after implantation.
Retrospective case review.
Tertiary referral university hospital.

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Jun
2017

To test the hypothesis that bipolar electrical impedance measurements in perimodiolar cochlear implants (CIs) may be used to differentiate between perimodiolar insertion technique favoring proximity to the modiolus or lateral wall.
Bipolar impedances are a measure of electrical resistance between pairs of electrode contacts in a CI. Stimulation is through biphasic pulses at fixed frequency.

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Jul
2016

Subtotal petrosectomy combined with cochlear implantation is a procedure required in specific situations.
A retrospective review of all cases of subtotal petrosectomy in cochlear implant surgery over a five-year period was performed. The indications, complications and outcomes for this procedure are outlined.

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Jan
2017

The objective of this historical cohort study is to identify if there are differences in soft tissue reactions and skin thickening between implantation of the percutaneous bone-anchored hearing implant (BAHI) using the dermatome or linear incision technique. All adult patients who received a BAHI between August 2005 and January 2013 were selected. One surgeon performed all procedures and only the dermatome and linear incision technique were used.

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Dec
1969

The round window insertion (RWI) and cochleostomy approaches are the 2 most common surgical techniques used in cochlear implantation (CI). However, there is no consensus on which approach is ideal for electrode array insertion, in part because visualization of intracochlear electrode position is challenging, so postoperative assessment of intracochlear electrode contact is lacking.
To measure and compare electrode array position between RWI and cochleostomy approaches for CI insertion.

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Dec
1969

To review the contemporary surgical issues in paediatric cochlear implantation (CI) based on published evidence.
Narrative literature review.
Surgical challenges in paediatric CI are discussed, with respect to post meningitic labyrinthitis ossificans; cochlear malformation; cochlear implantation in infants; auditory neuropathy and cochlear nerve deficiency; bilateral cochlear implantation; hearing preservation; otitis media; and device failure.

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Jun
2016

CSF Gusher in Cochlear Implant Surgery-does it affect surgical outcomes?

Eur Ann Otorhinolaryngol Head Neck Dis 2016 Jun 30;133 Suppl 1:S21-4. Epub 2016 May 30.
S Vashist, S Singh
The purpose of this prospective study was to measure surgical outcomes in cases of cerebrospinal fluid gusher in cochlear implant surgery.
Demographic, radiological, neurophysiological and surgical results were evaluated in nine cases of patients with cerebrospinal fluid gusher during cochlear implant surgery, out of 164 unilateral cochlear implant procedures. Review of literature and our management technique is discussed.

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Jun
2016

The rational for a mid-scala electrode array.

Eur Ann Otorhinolaryngol Head Neck Dis 2016 Jun 27;133 Suppl 1:S61-2. Epub 2016 May 27.
P J Boyle
Today increasing numbers of cochlear implant candidates have residual hearing that can be aided and hence is worth trying to preserve. This means that surgical technique and electrode array design must be adapted to minimize trauma. Wide opening of the round window is often preferred to reduce drill related trauma and to avoid pressure spikes during electrode array insertion.

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May
2016

This case report aims to emphasize the importance of preoperative computed tomography to evaluate the anatomy of the facial recess (FR) in order to prevent complications during cochlear implantation (CI) and to discuss alternative surgical approaches for the management of a narrow FR. Failure to notice this anomaly may result in facial nerve (FN) injury or inability to complete CI.
A 50-year-old female with bilateral sensorineural hearing loss presented for CI.

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Dec
1969

Although rare, complications in cochlear implantation may result from surgical or technical mishaps, reaction to the foreign body, infection, or mechanical device failure. Delayed cerebrospinal fluid (CSF) leak is a rarely reported condition that may present with asymptomatic swelling over the receiver-stimulator (RS). In our practice, meticulous drilling of a bony well is important in preventing device migration and maintaining a low device profile but there is the potential for immediate or delayed complication from this technique.

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Feb
2017

Cochlear implants (CI) are electronic devices that enable the auditory rehabilitation and the management of individuals with severe to profound bilateral hearing loss, and nowadays, advanced age is not considered a contraindication for cochlear implantation and several studies have shown that older adults do benefit from CI, with improvements in hearing abilities and quality of life.
Retrospective analysis of patients older than 18 years who underwent cochlear implant surgery in a tertiary academic centre.
57 patients met the inclusion criteria: 25 (43.

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Jul
2016

In children with X-linked deafness, cochlear malformations challenge the implant surgeon to avoid electrode insertion into the internal auditory meatus and prevent a continuous cerebrospinal fluid (CSF) leak. We describe our experience of cochlear implantation (CI) in two children with profound hearing loss secondary to X-linked deafness, highlighting safer operative techniques to avoid potential complications.
Descriptive cases of two children with X-linked deafness (patient 1 and patient 2) undergoing CI.

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Dec
1969

Although cochlear implantation is a relatively safe procedure, there is some reticence to subject elderly people, especially those with significant comorbidity, to the risks of general anesthesia. The purpose of the study was to explore the feasibility of cochlear implant surgery under local anesthesia and sedation in elderly people.
Case report study (Clinical Capsule Report).

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Nov
2016

The objective of this historical cohort study was to compare soft tissue reactions in adults after bone-anchored hearing implant (BAHI) surgery when the percutaneous implant is placed inside or outside the line of incision. All adult patients who received a percutaneous BAHI between 1 January 2010 and 31 January 2014 in our tertiary referral centre were identified. Patients were selected if operated by two surgeons, who perform the same standardised linear incision technique with one of them placing the implant outside the incision while the other prefers placement inside the line of incision.

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Jul
2016

The mCI surgical technique led to reduced impedance and minimized disturbance of the microenvironment inside the cochlea. Atraumatic surgical techniques and inflammation-reduction strategies may preserve the cochlear architecture and prevent fibrotic development.
To assess the advantages of a modified minimal access technique in cochlear implantation as well as to investigate the effects of intra-operative application of inflammation reduction strategies on the intra-cochlear impedance.

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Oct
2015

[Advances in minimally invasive cochlear implantation].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015 Oct;29(19):1754-8
Shilong Sun, Furong Ma
Cochlear implantation has gradually been accepted as an effective treatment for many patients with severe to pround sensorineural hearing loss. The traditional cochlear implantation does not exist up to expectations in some respects. With the soft surgery technique brought forward, the idea of minimally invasive cochlear implantation is deely rooted among the people.

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Oct
2016

Preservation of residual hearing in cochlear implantation is a main concern for patients and otologists. New electrode arrays as well as development of minimally invasive technique have allowed the expansion of indication criteria for cochlear implantation. The loss of residual low-frequency hearing is thought to be the result of many factors.

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Apr
2016

To investigate the clinical outcome of a surgical technique with tissue preservation for a wide bone-anchored hearing implant concerning postoperative complications, skin reactions, implant loss, and implant stability.
Consecutive, prospective case series.
Tertiary referral center.

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Apr
2016

To describe a method of cochlear implantation in which the opening of the cochlea and the electrode array insertion are performed under water (underwater technique).
Retrospective patient review.
Academic tertiary referral center.

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