Department of Otorhinolaryngology Head and Neck Surgery & Department of Radiology, Mayo Clinic School of Medicine, Rochester, Minnesota 55905, USA.
Laryngoscope. 2011 Jul;121(7):1508-16. doi: 10.1002/lary.21837. Epub 2011 May 3.
OBJECTIVES/HYPOTHESIS: To compare electrode array position, and depth of insertion of the Cochlear Hybrid-L24 electrode array following traditional cochleostomy and round window (RW) insertion.
Prospective cadaveric temporal bone study.
Ten cadaveric temporal bones were implanted with the Hybrid-L24 electrode array; half were introduced through a RW approach, whereas the other half were inserted through a traditional scala tympani cochleostomy. A micro-CT scanner was then used to evaluate electrode position, intracochlear trauma, and depth of insertion.
All electrodes were inserted into the scala tympani without significant resistance. No electrodes demonstrated tip fold-over or through-fracturing of the osseous spiral lamina, basilar membrane, or spiral ligament. The average angular depth of insertion for all 10 electrodes was 252.4°. Compared to cochleostomy insertions, electrodes inserted through the RW more commonly acquired a proximal perimodiolar orientation, followed a more predictable course, and less commonly contacted critical soft tissue structures.
The results of this study demonstrate that the Hybrid-L24 electrode can be successfully inserted using a RW or traditional cochleostomy technique with minimal intracochlear trauma. Our data also suggests that with this model, RW insertions may provide particular advantages with respect to hearing preservation over the traditional cochleostomy approach.
目的/假设:比较传统的耳蜗造瘘术和圆窗(RW)入路植入 Cochlear Hybrid-L24 电极阵列时的电极位置和插入深度。
前瞻性尸体颞骨研究。
将 Hybrid-L24 电极阵列植入 10 具尸体颞骨;一半通过 RW 入路引入,另一半通过传统的鼓阶耳蜗造瘘术插入。然后使用微 CT 扫描仪评估电极位置、耳蜗内创伤和插入深度。
所有电极均无明显阻力插入鼓阶。没有电极表现出尖端折叠或骨螺旋板、基底膜或螺旋韧带的穿透性骨折。所有 10 个电极的平均角插入深度为 252.4°。与耳蜗造瘘术插入相比,通过 RW 插入的电极更常见地获得近中内毛细胞取向,遵循更可预测的轨迹,并且不太常见地接触到关键的软组织结构。
本研究结果表明,Hybrid-L24 电极可以使用 RW 或传统的耳蜗造瘘术技术成功插入,并且对耳蜗内组织创伤最小。我们的数据还表明,对于这种模型,RW 插入术可能在听力保护方面相对于传统的耳蜗造瘘术方法具有特别的优势。