Mittmann Philipp, Mittmann Marlene, Ernst Arneborg, Todt Ingo
1 Department of Otolaryngology-Head and Neck Surgery, Unfallkranken-haus Berlin, Berlin, Germany.
Otolaryngol Head Neck Surg. 2017 Apr;156(4):712-716. doi: 10.1177/0194599816684104. Epub 2016 Dec 27.
Objective To preserve residual hearing in cochlear implant surgery, the electrode design has been refined, and an atraumatic insertion has become one aspect of cochlear implant research. Previous studies have described the effect of insertion speed and opening of the round window membrane on intracochlear pressure changes. The aim of our current study was to observe intracochlear pressure changes due to different cochlear implant electrodes in an artificial cochlear model with stable surrounding factors. Study Design Prospective controlled study. Setting Tertiary referral center. Subjects and Methods The experiments were performed in an artificial cochlear model with a pressure sensor in the apical area. With straight and perimodiolar electrode arrays, 5 insertions with the same insertion speed and 5 insertions over the same time were performed. Results With the perimodiolar high-volume electrode, significantly greater intracochlear fluid pressure changes were observed than with the straight electrode. Compared with the straight electrode, the perimodiolar electrode induces significantly higher pressure peaks (1.12 ± 0.15 vs 0.86 ± 0.05 mm Hg, P = .006) and significantly higher amplitudes (0.38 ± 0.07 vs 0.09 ± 0.07 mm Hg, P < .001). Conclusion The reliable preservation of residual hearing is an important multifactorial challenge in modern cochlear implant surgery. Insertion speed, handling, and electrode design are known to influence the preservation of residual hearing. In our artificial model experiments, we could prove objectively that the volume of the electrodes has a significant influence on the intracochlear pressure changes during cochlear implantation.
目的 在人工耳蜗模型中，为了在人工耳蜗植入手术中保留残余听力，电极设计已得到改进，无创伤插入已成为人工耳蜗研究的一个方面。以往的研究描述了插入速度和圆窗膜开放对耳蜗内压力变化的影响。我们当前研究的目的是在周围因素稳定的人工耳蜗模型中，观察不同人工耳蜗电极引起的耳蜗内压力变化。研究设计 前瞻性对照研究。地点 三级转诊中心。对象与方法 实验在顶端区域带有压力传感器的人工耳蜗模型中进行。使用直电极阵列和蜗轴周围电极阵列，以相同的插入速度进行5次插入，并在相同时间内进行5次插入。结果 与直电极相比，使用蜗轴周围大容量电极时，观察到耳蜗内液体压力变化明显更大。与直电极相比，蜗轴周围电极引起的压力峰值明显更高（1.12±0.15 vs 0.86±0.05 mmHg，P = 0.006），幅度也明显更高（0.38±0.07 vs 0.09±0.07 mmHg，P < 0.001）。结论 在现代人工耳蜗植入手术中，可靠地保留残余听力是一项重要的多因素挑战。已知插入速度、操作和电极设计会影响残余听力的保留。在我们的人工模型实验中，我们可以客观地证明电极的体积对人工耳蜗植入过程中的耳蜗内压力变化有显著影响。
