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一种用于人工耳蜗电极插入和力评估的模型:采用新型电极设计和插入技术的结果

A model for cochlear implant electrode insertion and force evaluation: results with a new electrode design and insertion technique.

作者信息

Roland J Thomas

机构信息

Department of Otolaryngology and Neurosurgery, New York University School of Medicine, 550 First Avenue, New York, NY 10016, U.S.A.

出版信息

Laryngoscope. 2005 Aug;115(8):1325-39. doi: 10.1097/01.mlg.0000167993.05007.35.

Abstract

OBJECTIVES AND HYPOTHESIS

This study has the specific aim of evaluating the insertion characteristics of a new cochlear implant electrode. Techniques for evaluation of fluoroscopic real time mechanical insertion dynamics, histologic electrode position and trauma results, hydraulic force, and mechanical insertion forces are presented. In addition, this study should serve to present a novel model for cochlear implant electrode insertion evaluations.

STUDY DESIGN

Prospective analysis using a series of analytical techniques.

METHODS

All studies are conducted in fixed cadaveric temporal bones. Real time fluoroscopic insertion evaluations, histologic evaluations for trauma and electrode position in embedded bones, hydraulic measures, and mechanical intracochlear force measurements are conducted with a current and new electrode.

RESULTS

The Contour Advance electrode provides a more reliable and less traumatic insertion when deployed with the Advance Off Stylet technique. This is largely because of a reduction in intracochlear outer wall force generation. Fluoroscopic and histologic analysis reveal a smooth insertion without reliance on cochlear outer wall contact. No hydraulic forces were detected when measured from the superior semicircular canal ampulla.

CONCLUSION

The model used for this study provides valuable information to cochlear implant surgeons and design engineers. The Contour Advance electrode, inserted with the Advance Off Stylet technique, represents an improvement over the Contour electrode inserted with the standard insertion technique.

摘要

目的与假设

本研究的具体目的是评估一种新型人工耳蜗电极的插入特性。介绍了用于评估荧光透视实时机械插入动力学、组织学电极位置和创伤结果、液压以及机械插入力的技术。此外,本研究应有助于提出一种用于人工耳蜗电极插入评估的新模型。

研究设计

采用一系列分析技术进行前瞻性分析。

方法

所有研究均在固定的尸体颞骨上进行。使用当前电极和新型电极进行实时荧光透视插入评估、对嵌入骨中的创伤和电极位置进行组织学评估、液压测量以及耳蜗内机械力测量。

结果

采用“推进式无探丝”技术部署时,Contour Advance电极插入更可靠且创伤更小。这主要是因为耳蜗外壁产生的力有所减少。荧光透视和组织学分析显示插入过程顺畅,无需依赖与耳蜗外壁接触。从上半规管壶腹测量时未检测到液压。

结论

本研究使用的模型为人工耳蜗外科医生和设计工程师提供了有价值的信息。采用“推进式无探丝”技术插入的Contour Advance电极相较于采用标准插入技术插入的Contour电极有所改进。

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