Shapira Yisgav, Eshraghi Adrien A, Balkany Thomas J
University of Miami Ear Institute, Department of Otolaryngology, University of Miami Miller School of Medicine, FL, USA.
Acta Otolaryngol. 2011 Mar;131(3):284-9. doi: 10.3109/00016489.2010.533698. Epub 2010 Dec 28.
In this study round window (RW) insertion of cochlear implant was performed with a lower degree of trauma in 86.6% of cases. Therefore RW insertion is a valid option to be considered in selected cochlear implant patients, especially when hearing preservation is a goal. In most cases drilling of the overhangs is required.
To systematically examine the potential for minimizing electrode insertion trauma with RW insertion.
Fifteen temporal bones were inserted with a 0.5 mm electrode analog in an anterior or antero-inferior vector from a reference point along the facial recess. Surface preparation of the inferior segment of the basal turn was performed and the point of first contact was analyzed using computerized morphometric software. The same software was used to measure the RW dimensions before and after drill down of the bony overhangs. An insertion was considered 'traumatic' if the point of first contact was the medial wall of the scala, whereas 'less traumatic' was an insertion in which the point of first contact was the inferior or posterior wall of the scala.
Less traumatic insertion was achieved in 13 of the 15 bones, and in these the mean RW angle, as observed from a surgical point of view, was 137°. The mean RW angle in the traumatic insertion group was 147°. The difference was statistically significant.
在本研究中，86.6%的病例采用圆窗（RW）植入人工耳蜗，创伤程度较低。因此，对于部分人工耳蜗植入患者，尤其是以听力保留为目标时，RW植入是一个值得考虑的有效选择。在大多数情况下，需要磨除悬突。
系统研究通过RW植入将电极插入创伤降至最低的可能性。
沿面神经隐窝从参考点以0.5毫米电极模拟物在15个颞骨中以前方或前下方方向插入。对蜗底段进行表面处理，并使用计算机形态测量软件分析首次接触点。在磨除骨悬突前后，使用相同软件测量RW尺寸。如果首次接触点是蜗管的内侧壁，则插入被认为是“有创的”，而首次接触点是蜗管的下壁或后壁的插入则是“创伤较小的”。
15块颞骨中有13块实现了创伤较小的插入，从手术角度观察，这些颞骨的平均RW角度为137°。有创插入组的平均RW角度为147°。差异具有统计学意义。
