Richter B, Aschendorff A, Lohnstein P, Husstedt H, Nagursky H, Laszig R
Departments of Otorhinolaryngology-Head and Neck Surgery, University Clinic Freiburg, Killianstrasse 5, D-79106 Frieburg Br., Germany.
Laryngoscope. 2001 Mar;111(3):508-14. doi: 10.1097/00005537-200103000-00023.
To evaluate the handling and insertion trauma of the recently developed Nucleus perimodiolar Contour electrode array (Cochlear Ltd., Pty, Lane Cove, New South Wales, Australia) in human temporal bones compared with the Nucleus standard straight electrode array.
E-perimental control group.
Twenty-nine fresh-frozen bones were implanted with different electrode arrays by an experienced cochlear implant surgeon, and evaluated both radiologically and histologically.
Intracochlear insertion of the standard Nucleus straight electrode array was found to be atraumatic, confirming previous findings in the literature. Insertion of the Nucleus Contour electrode array resulted in instances of localized basilar membrane penetration causing the electrode array to move from the scala tympani into the scala vestibuli. However, this trauma did not result in any observable damage to the osseous spiral lamina or the modiolus. Basilar membrane penetration was observed in six of eight cochlear bones when a standard cochleostomy size (approximately 0.8 mm) and site (anterior and superior to the round window) were used. However, when the surgical technique was modified to use a slightly larger cochleostomy ( approximately 1.8 mm) situated closer to the round window and employ a partial stylet withdrawal technique during electrode insertion, the frequency of penetrations was restricted to two of seven bones. This trauma rate is comparable to that observed with other cochlear implants designs.
Following our results, the design of the Nucleus Contour electrode appears to fulfill the safety requirements for an intracochlear electrode array, provided that the surgical insertion technique is modified in the manner outlined.
与Nucleus标准直电极阵列相比，评估最近开发的Nucleus蜗周轮廓电极阵列（澳大利亚新南威尔士州莱恩科夫市科利耳有限公司）在人颞骨中的操作及插入创伤情况。
实验对照组。
由一位经验丰富的人工耳蜗外科医生将不同的电极阵列植入29块新鲜冷冻骨中，并进行放射学和组织学评估。
发现标准Nucleus直电极阵列在耳蜗内插入时无创伤，这证实了文献中先前的研究结果。Nucleus轮廓电极阵列插入时出现局部基底膜穿透的情况，导致电极阵列从鼓阶移入前庭阶。然而，这种创伤并未对骨螺旋板或蜗轴造成任何可观察到的损伤。当采用标准的蜗窗造口尺寸（约0.8毫米）和位置（蜗窗前方和上方）时，在8块耳蜗骨中有6块观察到基底膜穿透。然而，当手术技术改进为使用稍大一点的蜗窗造口（约1.8毫米），位置更靠近蜗窗，并在电极插入过程中采用部分针芯回撤技术时，穿透频率限制在7块骨中的2块。这种创伤率与其他人工耳蜗设计所观察到的相当。
根据我们的结果，Nucleus轮廓电极的设计似乎满足耳蜗内电极阵列的安全要求，前提是按照所述方式改进手术插入技术。
