Dhanasingh Anandhan
MED-EL GmbH, R-D, Innsbruck, Austria.
J Int Adv Otol. 2018 Dec;14(3):376-381. doi: 10.5152/iao.2018.5831.
The question of why pre-curved modiolar hugging (MH) electrodes only cover the basal turn of the cochlea and not beyond that is unanswered yet in the CI field. Therefore the aim of this article is to show what the practical limitations are with the pre-curved MH electrode design in not being able to fabricate beyond one full turn. Every CI electrode design needs a metal mold with grooves for placing the platinum wires and for injecting with the silicone elastomer. Limitations in making a mold with groove that goes beyond one full turn of curvature along with the mechanical deformation of the curved silicone elastomer, prevents making a pre-curved MH electrode beyond one full turn. Electrode tip fold-over, electrode scalar deviation and the inconsistent electrode to modiolus wall proximity are the reported issues with this electrode type which does not help by any means to the operating surgeon and the pediatric candidates especially. If intra-operative imaging is recommended to confirm the proper placement of the electrode for one particular electrode design, then how many clinics in the world may have this facility and is it ethical to put the patient under more radiation risk are the natural questions that needs to be answered in the interest of the patient. Every CI brand should come out of their marketing philosophy and innovate what is essential in bringing the full benefit of the device to the patients.
在人工耳蜗领域，预弯曲蜗轴环抱（MH）电极为何仅覆盖耳蜗的基底转而非更远部位这一问题尚未得到解答。因此，本文的目的是展示预弯曲MH电极设计在无法制造超过一整圈时的实际局限性。每种人工耳蜗电极设计都需要一个带有凹槽的金属模具，用于放置铂丝并注入硅橡胶弹性体。制造一个曲率超过一整圈的带有凹槽的模具存在局限性，同时弯曲的硅橡胶弹性体也会发生机械变形，这使得无法制造超过一整圈的预弯曲MH电极。电极尖端折叠、电极向蜗管偏移以及电极与蜗轴壁的接近程度不一致是该电极类型所报告的问题，这对手术医生尤其是儿科患者毫无帮助。如果建议术中成像以确认一种特定电极设计的电极正确放置，那么世界上有多少诊所具备这种设备，以及让患者承受更多辐射风险是否符合伦理道德，这些都是为了患者利益需要回答的自然问题。每个人工耳蜗品牌都应摒弃其营销理念，创新出能为患者带来设备全部益处的关键要素。
