Lauer Gina, Uçta Julica, Decker Lars, Ernst Arneborg, Mittmann Philipp
Department of Otolaryngology at UKB, Hospital of the University of Berlin Charité Medical School Berlin Germany.
Laryngoscope Investig Otolaryngol. 2019 Jul 11;4(4):441-445. doi: 10.1002/lio2.295. eCollection 2019 Aug.
Different aspects should be considered to achieve an atraumatic insertion of cochlear implant electrode arrays as an important surgical goal. Intracochlear pressure changes are known to influence the preservation of residual hearing. By using the intraoperative "pullback technique," an electrode position closer to the modiolus can be achieved than without the pullback. The aim of the present study was therefore to investigate to what extent the pullback technique can influence intracochlear pressure changes.
Insertions of cochlear implant electrodes were performed in an artificial cochlear model with two different perimodiolar arrays. Intracochlear pressure changes were recorded with a micro-optical pressure sensor positioned in the apical part of the cochlear. After complete insertion of the electrode array, a so-called pullback of the electrode was performed.
Statistically significant pressure differences were measured if the electrode array was wet (ie, moisturized) during the pullback. Relative pressure changes in electrodes with smaller total volume are lower than pressure changes in larger electrodes.
The preservation of residual hearing and, thus, the resulting postoperative audiological outcome has a major impact on the quality of life of the patients and has become of utmost importance. Intracochlear pressure changes during the pullback manoeuver are small in absolute terms, but can even be still reduced statistically significantly by a moistening the electrode before insertion. Using the pullback technique in cases with residual hearing does not affect the probability of preservation of residual hearing but could lead to a better audiological outcome.
NA.
作为一项重要的手术目标，实现人工耳蜗电极阵列的无创插入需要考虑多个方面。已知耳蜗内压力变化会影响残余听力的保留。通过术中“回拉技术”，可使电极位置比不进行回拉时更靠近蜗轴。因此，本研究的目的是探讨回拉技术在多大程度上会影响耳蜗内压力变化。
在具有两种不同蜗轴周围阵列的人工耳蜗模型中进行人工耳蜗电极插入。使用位于耳蜗顶部的微光学压力传感器记录耳蜗内压力变化。电极阵列完全插入后，进行电极的所谓回拉操作。
如果在回拉过程中电极阵列是湿的（即湿润的），则可测量到具有统计学意义的压力差异。总体积较小的电极中的相对压力变化低于较大电极中的压力变化。
残余听力的保留以及由此产生的术后听力结果对患者的生活质量有重大影响，并且变得至关重要。回拉操作期间耳蜗内的压力变化绝对值较小，但通过在插入前湿润电极甚至可在统计学上显著降低。在有残余听力的情况下使用回拉技术不会影响保留残余听力的可能性，但可能会带来更好的听力结果。
无。
