*Department of Otolaryngology-Head and Neck Surgery, Tohoku University School of Medicine; and †Division of Otorhinolaryngology, Sendai Municipal Hospital, Sendai, Japan.
Otol Neurotol. 2014 Feb;35(2):234-40. doi: 10.1097/MAO.0b013e3182a36018.
Preservation of residual hearing during cochlear implantation is important. This study investigated changes in endocochlear potential (EP) during simulated cochlear implant (CI) electrode insertion.
Laboratory animal study.
Academic hospital laboratory.
Guinea pigs were divided into 4 groups: cochleostomy only (4 animals), suction after cochleostomy (5 animals), simulated CI electrode insertion parallel to the longitudinal axis of the scala tympani without suctioning (7 animals), and simulated CI electrode insertion toward the modiolus without suctioning (7 animals). The EP was measured from the second turn of the cochlea, and the values after 20 minutes were compared.
The EP showed little change at 20 minutes after cochleostomy with a nearly normal value of 84.83 ± 2.12 mV. Suctioning of the perilymph from the cochleostomy site caused a slight acute reduction in EP by about 6 mV, and the value at 20 minutes after cochleostomy was 78.64 ± 4.42 mV. Insertion of the simulated CI electrode parallel to the longitudinal axis of the scala tympani caused a slight decrease in EP to 78.91 ± 5.06 mV. Insertion toward the modiolus caused a marked decrease in EP to 54.13 ± 4.42 mV at 20 minutes after the treatment, significantly lower compared with the other 3 groups.
EP was well preserved during carefully performed surgical procedures of simulated CI electrode insertion, but it decreased significantly if the simulated CI electrode was inserted toward the modiolus. Careful attention is necessary to ensure the correct direction of CI electrode insertion to preserve residual hearing. Use of suction should be minimized if possible.
在耳蜗植入过程中保留残余听力非常重要。本研究旨在探讨模拟耳蜗植入(CI)电极插入过程中内淋巴电位(EP)的变化。
实验室动物研究。
学术医院实验室。
将豚鼠分为 4 组:单纯耳蜗造瘘术组(4 只)、耳蜗造瘘术后吸引组(5 只)、模拟 CI 电极平行于耳蜗鼓阶长轴插入而不吸引组(7 只)和模拟 CI 电极向蜗轴方向插入而不吸引组(7 只)。从耳蜗第二圈测量 EP,比较 20 分钟后的数值。
耳蜗造瘘术后 20 分钟,EP 变化不大,接近正常的 84.83±2.12mV。从耳蜗造瘘口吸出外淋巴液会导致 EP 轻微急性下降约 6mV,耳蜗造瘘术后 20 分钟时的 EP 值为 78.64±4.42mV。模拟 CI 电极平行于耳蜗鼓阶长轴插入会导致 EP 轻微下降,至 78.91±5.06mV。向蜗轴方向插入则会导致 EP 明显下降,处理后 20 分钟时降至 54.13±4.42mV,明显低于其他 3 组。
在仔细进行模拟 CI 电极插入手术时,EP 得到很好的保留,但如果模拟 CI 电极向蜗轴方向插入,EP 会显著下降。为了保护残余听力,在进行 CI 电极插入时应特别注意正确的方向。如果可能的话,应尽量减少吸引的使用。