Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee, USA.
Audiol Neurootol. 2022;27(2):104-108. doi: 10.1159/000515684. Epub 2021 Apr 29.
Translocation of precurved cochlear implant (CI) electrodes reduces hearing outcomes, but it is not known whether it is possible to correct scalar translocation such that all electrodes reside fully in the scala tympani (ST).
Six cadaveric temporal bones were scanned with CT and segmented to delineate intracochlear anatomy. Mastoidectomy with facial recess was performed. Precurved CI electrodes (CI532; Cochlear Limited) were implanted until scalar translocation was confirmed with postoperative CT. Then, electrodes were removed and replaced. CT scan was repeated to assess for translocation correction. Scalar position of electrode contacts, angular insertion depth (AID) of the electrode array, and M- (average distance between each electrode contact and the modiolus) were measured. An in vivo case is reported in which intraoperative translocation detection led to removal and replacement of the electrode.
Five of 6 cadaveric translocations (83%) were corrected with 1 attempt, resulting in full ST insertions. AID averaged 285 ± 77° for translocated electrodes compared to 344 ± 28° for nontranslocated electrodes (p = 0.109). M- averaged 0.75 ± 0.18 mm for translocated electrodes and 0.45 ± 0.11 mm for nontranslocated electrodes (p = 0.016). Reduction in M- with translocation correction averaged 38%. In the in vivo case, translocation was successfully corrected in a single attempt.
Scalar translocation of precurved CI electrodes can be corrected by removal and reinsertion. This significantly improves the perimodiolar positioning of these electrodes. There was a high rate of success (83%) in this cadaveric model as well as a successful in vivo attempt.
预弯耳蜗植入（CI）电极的转位会降低听力效果，但目前尚不清楚是否有可能纠正标量转位，以使所有电极完全位于鼓阶（ST）内。
对 6 例尸体颞骨进行 CT 扫描和分割，以描绘内耳蜗解剖结构。进行乳突切除术和面隐窝切开术。植入预弯 CI 电极（CI532；Cochlear Limited），直到术后 CT 确认发生标量转位。然后，取出并更换电极。重复 CT 扫描以评估转位纠正情况。测量电极接触的标量位置、电极阵列的角插入深度（AID）以及 M-（每个电极接触与蜗轴之间的平均距离）。报告了 1 例术中转位检测导致电极取出和更换的体内病例。
在 6 例尸体标本中，有 5 例（83%）转位通过 1 次尝试得到纠正，从而实现了完全的 ST 插入。与未转位电极相比，转位电极的 AID 平均为 285±77°，而非转位电极的 AID 平均为 344±28°（p=0.109）。转位电极的 M-平均为 0.75±0.18mm，而非转位电极的 M-平均为 0.45±0.11mm（p=0.016）。转位纠正后 M-的平均减少量为 38%。在体内病例中，转位成功地在一次尝试中得到纠正。
预弯 CI 电极的标量转位可以通过取出和重新插入来纠正。这显著改善了这些电极的 peri-modiolar 定位。在这个尸体模型中，成功率很高（83%），并且在体内尝试中也取得了成功。
