Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Otolaryngology/Head & Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Otol Neurotol. 2024 Jul 1;45(6):e460-e467. doi: 10.1097/MAO.0000000000004222.
Misplacement of electrode arrays in the internal auditory canal (IAC) presents a unique clinical challenge. Speech recognition is limited for cochlear implant (CI) users with misplaced arrays, and there are risks with revision surgery including facial and/or cochlear nerve injury.
PubMed, Embase, and Scopus.
A literature search was performed from inception to September 2023. The search terms were designed to capture articles on misplaced arrays and the management options. Articles written in English that described cases of array misplacement into the IAC for children and adults were included. The level of evidence was assessed using Oxford Center for Evidence Based Medicine guidelines. Descriptive statistical analyses were performed.
Twenty-eight cases of arrays misplaced in the IAC were identified. Thirteen (46%) were patients with incomplete partition type 3 (IP3), and 7 (25%) were patients with common cavity (CC) malformations. Most misplaced arrays were identified postoperatively (19 cases; 68%). Of these cases, 11 (58%) were managed with array removal. No facial nerve injuries were reported with revision surgery. Eight cases (42%) were left in place. Several underwent mapping procedures in an attempt improve the sound quality with the CI.
Electrode array misplacement in the IAC is a rare complication that reportedly occurs predominately in cases with IP3 and CC malformations. Removal of misplaced arrays from the IAC reportedly has not been associated with facial nerve injuries. Cases identified with IAC misplacement postoperatively can potentially be managed with modified mapping techniques before proceeding with revision surgery.
电极阵列在内耳（IAC）中的错位会带来独特的临床挑战。对于电极阵列错位的人工耳蜗（CI）使用者，言语识别能力有限，并且修正手术存在面神经和/或耳蜗神经损伤的风险。
PubMed、Embase 和 Scopus。
从建库到 2023 年 9 月进行了文献检索。检索词旨在捕获有关电极阵列错位和管理选项的文章。纳入了描述儿童和成人电极阵列错位到 IAC 的病例以及管理选项的英文文章。使用牛津循证医学中心指南评估证据水平。进行描述性统计分析。
确定了 28 例电极阵列错位到 IAC 的病例。13 例（46%）为不完全分隔 3 型（IP3）患者，7 例（25%）为共同腔（CC）畸形患者。大多数错位阵列是术后发现的（19 例；68%）。这些病例中，11 例（58%）进行了阵列移除。修正手术中未报告面神经损伤。8 例（42%）留在原处。一些患者进行了映射程序，试图通过 CI 改善声音质量。
电极阵列在 IAC 中的错位是一种罕见的并发症，据报道主要发生在 IP3 和 CC 畸形的病例中。从 IAC 中移除错位的阵列据报道与面神经损伤无关。术后发现 IAC 错位的病例可以在进行修正手术之前，通过修改的映射技术进行潜在的管理。
