Pile Jason, Sweeney Alex D, Kumar Shaun, Simaan Nabil, Wanna George B
Department of Engineering, Vanderbilt University, Nashville, Tennessee, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Laryngoscope. 2017 Jun;127(6):1413-1419. doi: 10.1002/lary.26183. Epub 2016 Aug 24.
To test the hypothesis that bipolar electrical impedance measurements in perimodiolar cochlear implants (CIs) may be used to differentiate between perimodiolar insertion technique favoring proximity to the modiolus or lateral wall.
Bipolar impedances are a measure of electrical resistance between pairs of electrode contacts in a CI. Stimulation is through biphasic pulses at fixed frequency. Impedance measurements were made in real time through sequential sampling of electrode pairs. Perimodiolar electrodes were inserted in temporal bones using one of two techniques: 1) In the standard insertion technique (SIT), the electrode array slides along the lateral wall during insertion. 2) In the Advance Off Stylet (Cochlear Ltd. Sydney) technique (AOS), the electrode maintains modiolar contact throughout the insertion process. A set of 22 insertions were performed in temporal bone specimens using perimodiolar electrode arrays with both AOS and SIT. Buffered saline was used as a substitute for natural perilymph based on similar electrical conductivity properties. Impedance with and without stylet removal were recorded with a 30-second sampling window at final insertion depth.
There is a significant difference in bipolar impedance measures between AOS and SIT, with impedances rising in measurements with stylet removal. Evaluation was based on two-sided analysis of variance considering technique and electrode with P < 0.025.
Bipolar electrical impedance can be used to detect relative motion toward the modiolus inside the cochlea. This detection method has the potential to optimize intraoperative placement of perimodiolar electrode arrays during implantation. We anticipate that this will result in lower excitation thresholds and improved hearing outcome.
NA. Laryngoscope, 127:1413-1419, 2017.
验证以下假设，即使用蜗轴旁人工耳蜗（CI）进行双极电阻抗测量可用于区分蜗轴旁植入技术是更靠近蜗轴还是侧壁。
双极电阻抗是指人工耳蜗中电极触点对之间的电阻测量值。刺激通过固定频率的双相脉冲进行。通过对电极对的顺序采样实时进行电阻抗测量。使用两种技术之一将蜗轴旁电极插入颞骨：1）在标准插入技术（SIT）中，电极阵列在插入过程中沿侧壁滑动。2）在先进脱针技术（澳大利亚悉尼科利耳有限公司）（AOS）中，电极在整个插入过程中保持与蜗轴接触。使用AOS和SIT两种蜗轴旁电极阵列在颞骨标本中进行了22次插入。基于相似的电导率特性，使用缓冲盐水替代天然外淋巴。在最终插入深度时，使用30秒采样窗口记录有针和无针时的电阻抗。
AOS和SIT之间的双极电阻抗测量值存在显著差异，无针测量时电阻抗升高。评估基于考虑技术和电极的双侧方差分析，P < 0.025。
双极电阻抗可用于检测耳蜗内朝向蜗轴的相对运动。这种检测方法有可能在植入过程中优化蜗轴旁电极阵列的术中放置。我们预计这将导致更低的刺激阈值和更好的听力结果。
无。《喉镜》，2017年，第127卷，第1413 - 1419页。
