Todt Ingo, Utca Julica, Karimi Dania, Ernst Arne, Mittmann Philipp
Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus Berlin, Warenerstr.7, 12683, Berlin, Germany.
J Otolaryngol Head Neck Surg. 2017 May 11;46(1):40. doi: 10.1186/s40463-017-0218-y.
The inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage. In a surgically hearing preservational concept, low intracochlear pressure changes are of high importance. The aim of this study was to observe intracochlear pressure changes due to different sealing techniques in a cochlear model.
Cochlear implant electrode insertions were performed in an artifical cochlear model and the intracochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude of intracochlear pressure. Four different sealing conditions were compared: 1) overlay, 2) overlay with fascia pushed in, 3) donut-like fascia ring, 4) donut-like fascia ring pushed in.
We found statistically significant differences in the occurrence of maximum amplitude of intracochlear pressure peak changes related to sealing procedure comparing the different techniques. While the lowest amplitude changes could be observed for the overlay technique (0.14 mmHg ± 0.06) the highest values could be observed for the donut-like pushed in technique (1.79 mmHg ± 0.69).
Sealing the electrode inserted cochlea can lead to significant intracochlear pressure changes. Pushing in of the sealing tissue cannot be recommended.
植入的人工耳蜗电极在圆窗或耳蜗造口处进行覆盖，以防止感染和渗漏。在手术听力保留概念中，低耳蜗内压力变化至关重要。本研究的目的是观察耳蜗模型中不同密封技术引起的耳蜗内压力变化。
在人工耳蜗模型中进行人工耳蜗电极植入，并使用位于耳蜗模型顶端区域的微压力传感器并行记录耳蜗内压力变化，以跟踪耳蜗内压力的最大幅度。比较了四种不同的密封条件：1）覆盖，2）推入筋膜覆盖，3）环形筋膜环，4）推入环形筋膜环。
比较不同技术时，我们发现与密封程序相关的耳蜗内压力峰值变化最大幅度的发生存在统计学显著差异。虽然覆盖技术的幅度变化最低（0.14 mmHg±0.06），但推入环形筋膜环技术的幅度变化最高（1.79 mmHg±0.69）。
密封插入电极的耳蜗会导致显著的耳蜗内压力变化。不建议将密封组织推入。
