4.2 Article

On the Intracochlear Location of Straight Electrode Arrays After Cochlear Implantation: How Lateral Are Lateral Wall Electrodes?

Journal

OTOLOGY & NEUROTOLOGY
Volume 42, Issue 2, Pages 242-250

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MAO.0000000000002880

Keywords

Cochlear implants; Cone beam-computed tomography; Lateral wall electrodes; Scala vestibuli

Funding

  1. Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy-EXC 2177/1 [390895286]
  2. company MedEL, Austria

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The study utilized a retrospective analysis of patient data sets to examine the position of electrode arrays within the cochlea. Coating electrode contacts with swelling hydrogels proved effective in bridging the gap between the electrode array and the cochlear wall, facilitating focused electrical stimulation of individual spiral ganglion neurons. While there were no significant differences in the distances from each electrode contact to the cochlear walls within each patient, there were significant variations between different contacts within the same patient.
Objective: Cochlear implants are the gold standard for patients with severe sensorineural hearing loss. A focused electrical stimulation of individual spiral ganglion neurons has not been achieved yet because the scala tympani is a fluid-filled compartment and does not offer a matrix for neuritic outgrowth. Coating of the electrode contacts with swelling hydrogels could fill that gap between the electrode array and the medial wall of the cochlea. Therefore, the exact position of the electrode array within the scala tympani has to be known. Study Design: Retrospective analysis of patient data sets. Setting: Tertiary referral center. A total of 95 patients with cochlear implants from one manufacturer were included in this study. The lateral wall, the modiolar wall, and the cochlear implant electrode were segmented using OsiriX MD. For repositioning and reconstructing the respective contours and measuring distances, files were analyzed in MATLAB. The distances from the edge of each electrode contact to the cochlear walls showed no significant differences. But between the different contacts within each patient, there were significant differences. Around 180 degree insertion, electrodes start to get in contact with the lateral wall. The tip of the electrode array was always facing toward the modiolar wall independent of the length of the electrode. We established a method to analyze the position of electrodes within the cochlea.

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