Department of Otolaryngology At Ukb, Unfallkrankenhaus Berlin, Warener Str.7, 12683, Berlin, Germany.
Department of Radiology, Ukb Berlin, Berlin, Germany.
Eur Arch Otorhinolaryngol. 2020 Jan;277(1):31-35. doi: 10.1007/s00405-019-05653-9. Epub 2019 Sep 24.
It is important for the surgeon to determine the position of the CI electrode array during and after its placement within the cochlea. Most preferably, this should be within the scala tympani to obtain the best audiological outcome. Thus, misplacement into the scala vestibuli or tip fold-over should be prevented. Since there are different ways to ensure proper positioning of the electrode array within the scala tympani (e.g., intraoperative radiography, electrophysiological recordings), our study was aimed at detecting intraoperative electrophysiologic characteristics to better understand the mechanisms of those electrode tip fold-overs.
In a multi-centric, retrospective case-control series, patients with a postoperatively by radiography detected tip fold-over in perimodiolar electrodes were included. The point of fold-over (i.e., the electrode position) was determined and the intraoperative Auto-NRT recordings were analysed and evaluated.
Four patients were found to have an electrode tip fold-over (out of 85 implantees). Significant changes of the Auto-NRT recordings were not detected. All tip fold-overs occurred in the most apical part of the electrodes.
Cochlear implantation for hearing impaired patients plays a decisive role in modern auditory rehabilitation. Perimodiolar electrode arrays may fold over during the insertion and, hence, could have a negative impact on audiological outcome. Characteristic electrophysiologic changes to possibly predict this were not found in our series.
在 CI 电极阵列放置过程中和放置后，外科医生确定其在耳蜗内的位置非常重要。最理想的是，电极应位于鼓阶内，以获得最佳的听力结果。因此，应防止错误地进入前庭阶或尖端折叠。由于有不同的方法可以确保电极阵列在鼓阶内的正确定位（例如，术中放射照相、电生理记录），我们的研究旨在检测术中电生理特征，以更好地了解那些电极尖端折叠的机制。
在一项多中心、回顾性病例对照系列研究中，纳入了术后放射照相检查发现电极尖端在围绕耳蜗植入电极处折叠的患者。确定折叠点（即电极位置），并分析和评估术中自动 NRT 记录。
发现 4 例患者（85 名植入者中有 4 例）存在电极尖端折叠。未检测到自动 NRT 记录的显著变化。所有尖端折叠都发生在电极的最顶端部分。
对于听力受损的患者来说，耳蜗植入术在现代听觉康复中起着决定性的作用。围绕耳蜗植入电极在插入过程中可能会折叠，从而对听力结果产生负面影响。在我们的系列中，没有发现可能预测这种情况的特征性电生理变化。
