scholarly journals Automatic identification of cochlear implant electrode arrays for post-operative assessment

2011 ◽  
Author(s):  
Jack H. Noble ◽  
Theodore A. Schuman ◽  
Charles G. Wright ◽  
Robert F. Labadie ◽  
Benoit M. Dawant
Keyword(s):  
Cochlear Implant ◽  
Automatic Identification ◽  
Electrode Arrays ◽  
Operative Assessment

scholarly journals Hydraulic insertions of cochlear implant electrode arrays into the human cadaver cochlea: preliminary findings

2021 ◽  
Author(s):  
M. Geraldine ◽  
Thomas Lenarz ◽  
Thomas S. Rau
Keyword(s):  
Cochlear Implant ◽  
Outcome Measurement ◽  
Round Window ◽  
Handling Time ◽  
Human Cadaver ◽  
Hydraulic Actuator ◽  
Electrode Arrays ◽  
Non Invasive ◽  
Insertion Tool ◽  
Set Up

Abstract Objectives (1) To evaluate the feasibility of a non-invasive, novel, simple insertion tool to perform automated, slow insertions of cochlear implant electrode arrays (EA) into a human cadaver cochlea; (2) to estimate the handling time required by our tool. Methods Basic science study conducted in an experimental OR. Two previously anonymized human cadaver heads, three commercially available EAs, and our novel insertion tool were used for the experiments. Our tool operates as a hydraulic actuator that delivers an EA at continuous velocities slower than manually feasible. Intervention(s): the human cadaver heads were prepared with a round-window approach for CI surgery in a standard fashion. Twelve EA insertion trials using our tool involved: non-invasive fixation of the tool to the head; directing the tool to the round window and EA mounting onto the tool; automated EA insertion at approximately 0.1 mm/s driven by hydraulic actuation. Outcome measurement(s): handling time of the tool; post-insertion cone-beam CT scans to provide intracochlear evaluation of the EA insertions. Results Our insertion tool successfully inserted an EA into the human cadaver cochlea (n = 12) while being attached to the human cadaver head in a non-invasive fashion. Median time to set up the tool was 8.8 (7.2–9.4) min. Conclusion The first insertions into the human cochlea using our novel, simple insertion tool were successful without the need for invasive fixation. The tool requires < 10 min to set up, which is clinically acceptable. Future assessment of intracochlear trauma is needed to support its safety profile for clinical translation.

scholarly journals The Importance of Intraoperative Plain Radiographs during Cochlear Implant Surgery in Patients with Normal Anatomy

2021 ◽  
Vol 11 (9) ◽  
pp. 4144
Author(s):  
Ohad Cohen ◽  
Jean-Yves Sichel ◽  
Chanan Shaul ◽  
Itay Chen ◽  
J. Thomas Roland ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
Cost Effective ◽  
X Rays ◽  
Normal Anatomy ◽  
Electrode Arrays ◽  
Plain Radiographs ◽  
Hearing Function ◽  
Tertiary Center ◽  
Cochlear Implant Surgery

Although malpositioning of the cochlear implant (CI) electrode array is rare in patients with normal anatomy, when occurring it may result in reduced hearing outcome. In addition to intraoperative electrophysiologic tests, imaging is an important modality to assess correct electrode array placement. The purpose of this report was to assess the incidence and describe cases in which intraoperative plain radiographs detected a malpositioned array. Intraoperative anti-Stenver’s view plain X-rays are conducted routinely in all CI surgeries in our tertiary center before awakening the patient and breaking the sterile field. Data of patients undergoing 399 CI surgeries were retrospectively analyzed. A total of 355 had normal inner ear and temporal bone anatomy. Patients with intra or extracochlear malpositioned electrode arrays demonstrated in the intraoperative X-ray were described. There were four cases of electrode array malposition out of 355 implantations with normal anatomy (1.1%): two tip fold-overs, one extracochlear placement and one partial insertion. All electrodes were reinserted immediately; repeated radiographs were normal and the patients achieved good hearing function. Intraoperative plain anti-Stenver’s view X-rays are valuable to confirm electrode array location, allowing correction before the conclusion of surgery. These radiographs are cheaper, faster, and emit much less radiation than other imaging options, making them a viable cost-effective tool in patients with normal anatomy.

Magnetic Steering of Robotically Inserted Lateral-wall Cochlear-implant Electrode Arrays Reduces Forces on the Basilar Membrane In Vitro

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Cameron M. Hendricks ◽  
Matt S. Cavilla ◽  
David E. Usevitch ◽  
Trevor L. Bruns ◽  
Katherine E. Riojas ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Basilar Membrane ◽  
Lateral Wall ◽  
Electrode Arrays ◽  
Magnetic Steering

Preservation of Residual Hearing After Cochlear Implant Surgery With Deep Insertion Electrode Arrays

2019 ◽  
Vol 40 (4) ◽  
pp. e373-e380 ◽  
Author(s):  
Cristina Sierra ◽  
Manuela Calderón ◽  
Eduardo Bárcena ◽  
Alexandra Tisaire ◽  
Eduardo Raboso
Keyword(s):  
Cochlear Implant ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Implant Surgery ◽  
Deep Insertion ◽  
Cochlear Implant Surgery

Scala-Tympani Phantom With Cochleostomy and Round-Window Openings for Cochlear-Implant Insertion Experiments

2014 ◽  
Vol 8 (4) ◽  
Author(s):  
Lisandro Leon ◽  
Matt S. Cavilla ◽  
Michael B. Doran ◽  
Frank M. Warren ◽  
Jake J. Abbott
Keyword(s):  
Cochlear Implant ◽  
Coordinate System ◽  
Round Window ◽  
Scala Tympani ◽  
Electrode Arrays ◽  
Angular Measurements ◽  
Insertion Techniques

Experiments with scala-tympani (ST) phantoms are used to evaluate new electrode arrays and cochlear-implant insertion techniques. To date, phantoms have not accounted for clinical orientations and geometric differences between round-window (RW) insertions and anteroinferior cochleostomy insertions. For improved assessments of insertion experiments, we present a scala-tympani phantom that offers three distinct benefits over previous phantoms: it mimics the standard otologic position, it accommodates for both round-window and anteroinferior cochleostomy insertions, and it incorporates a visual coordinate system based on industry consensus making standardized angular measurements possible.

High resolution computed tomography and magnetic resonance imaging in the pre-operative assessment of cochlear implant patients

2003 ◽  
Vol 117 (9) ◽  
pp. 692-695 ◽  
Author(s):  
T. G. Gleeson ◽  
P. D. Lacy ◽  
M. Bresnihan ◽  
R. Gaffney ◽  
P. Brennan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Cochlear Implant ◽  
High Resolution Computed Tomography ◽  
Time Of Surgery ◽  
Surgical Access ◽  
Significant Difference ◽  
Mri Scans ◽  
Operative Assessment ◽  
Ct And Mri

Optimal imaging protocols for cochlear implantation have yet to be determined. Pre-operative computed tomography (CT) and magnetic resonance image (MRI) scans are used to assess cochlear anatomy and patency, to delineate surgical access, and to aid in choice of side for implantation. However, opinion still differs as to which modality provides more information in pre-operative assessment, or if, indeed, a combination of the two is superior.The first 88 patients on the Irish National Cochlear Implant Programme (NCIP) were retrospectively studied to determine the accuracy of pre-operative CT and MRI in predicting abnormalities at the time of surgery. Correlation with surgical findings was determined in three separate groups of patients (those who had CT only, those who had MRI only, and those who had both CT and MRI performed).Of the 24 patients that had both CT and MRI performed, both modalities had a 79 per cent correlation with surgical findings. CT and MRI reports concurred in 75 per cent of cases. Specificity and negative predictive value were high (86 per cent and 90 per cent, respectively). CT alone (47 cases) correlated with surgery in 39 cases (83 per cent); MRI alone (17 cases) correlated in 15 cases (88 per cent).The findings of this study suggest that CT and MRI are effective at predicting normal inner ear anatomy, and thus at predicting the patient and the cochlea most suitable for implantation. Both modalities are useful in determining the side of implantation, thus avoiding potential surgical difficulties in cases of unilateral abnormalities. There was no significant difference between the ability of MRI and CT to detect abnormalities at the time of surgery. In this series the combination of CT and MRI has not been shown to be superior to either modality used alone, although anecdotal evidence to the contrary was noted.

Electrode design and insertional depth-dependent intra-cochlear pressure changes: a model experiment

2017 ◽  
Vol 132 (3) ◽  
pp. 224-229 ◽  
Author(s):  
P Mittmann ◽  
A Ernst ◽  
I Todt
Keyword(s):  
Cochlear Implant ◽  
Fluid Pressure ◽  
Electrode Array ◽  
Lateral Wall ◽  
Peak Frequency ◽  
Peak Amplitude ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Pressure Peak ◽  
Pressure Changes

AbstractBackground:Preservation of residual hearing is one of the major goals in modern cochlear implant surgery. Intra-cochlear fluid pressure changes influence residual hearing, and should be kept low before, during and after cochlear implant insertion.Methods:Experiments were performed in an artificial cochlear model. A pressure sensor was inserted in the apical part. Five insertions were performed on two electrode arrays. Each insertion was divided into three parts, and statistically evaluated in terms of pressure peak frequency and pressure peak amplitude.Results:The peak frequency over each third part of the electrode increased in both electrode arrays. A slight increase was seen in peak amplitude in the lateral wall electrode array, but not in the midscalar electrode array. Significant differences were found in the first third of both electrode arrays.Conclusion:The midscalar and lateral wall electrode arrays have different intra-cochlear fluid pressure changes associated with intra-cochlear placement, electrode characteristics and insertion.

Atraumaticity Study of 2 Cochlear Implant Electrode Arrays

2014 ◽  
Vol 35 (4) ◽  
pp. 619-628 ◽  
Author(s):  
Manuel Manrique ◽  
Sebastián Picciafuoco ◽  
Raquel Manrique ◽  
Ignacio Sanhueza ◽  
Pablo Domínguez ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Arrays

scholarly journals Current criteria for selecting cochlear implant in deaf patients: a review

2021 ◽  
Vol 9 (1) ◽  
pp. 50
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Neural Plasticity ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Low Frequency ◽  
Hearing Preservation ◽  
Electrode Arrays ◽  
Profound Hearing Loss ◽  
Unilateral Deafness

Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures. The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical, audiological, radiological, and psychological diagnostic work-up. There are numerous changes are happening in cochlear implant candidacy. These have been associated with concomitant changes in surgical techniques, which enhanced the utility and safety of cochlear implantation. Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss. Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss. The advancement in designs of the cochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices. This review article aims to discuss the new concepts in the candidacy of the cochlear implant, cochlear implant in younger children and hearing preservation, a cochlear implant for unilateral deafness, bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.

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