Movements of cochlear implant electrodes inside the cochlea during insertion: An x-ray microscopy study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • K. B. Hüttenbrink - , Technische Universität Dresden, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde (Autor:in)
  • Th Zahnert - , Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde (Autor:in)
  • C. Jolly - , MED-EL GmbH (Autor:in)
  • G. Hofmann - , Technische Universität Dresden, Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde (Autor:in)

Abstract

Background: There are no satisfactory, noninvasive techniques currently available to visualize the cochlear implant (CI) electrode in a dynamic state as it is advanced inside the cochlea. Objective: This study describes a radiologic technique that can be used in temporal bones to monitor the electrode position in real time and to visualize the basilar membrane. Methods: A cochleostomy was performed in accordance with the normal procedure for cochlear implantation in seven fresh cadaveric temporal bones. A special x-ray tube (Microfocus; Focus, Wunstorf, Germany) with a spot size of 1 μm and fluoroscopy were used for continuous videotape imaging of the advancing electrode in the cochlea. Conventional electrodes (MED-EL 40+; MED-EL, Innsbruck, Austria) and prototypes of perimodiolar electrodes (MED-EL), with varying thicknesses and angles of insertion, were used for the study. Finally, contrast liquid (Ultravist; Berlex Imaging, Schering, Germany) was injected into the scala vestibuli through the stapes footplate. Results: The advancing electrode carrier was clearly visible at ×20 magnification. With the perimodiolar electrodes, deep insertion was impossible if the guiding wire was too rigid, and retraction occurred if the wire was soft. The intact nature of the basilar membrane could be confirmed by the sequential filling of scala vestibuli and the scala tympani. Conclusion: To our knowledge, this is the first noninvasive study demonstrating continuous visualization with high-resolution and x-ray magnification of CI electrode advancement inside the intact cochlea. Our technique can be used for the development of CI electrodes with optimal design characteristics, especially stiffness. Visualization of the basilar membrane will influence the insertion techniques when CIs are developed for patients with residual hearing.

Details

OriginalspracheEnglisch
Seiten (von - bis)187-191
Seitenumfang5
FachzeitschriftOtology and Neurotology
Jahrgang23
Ausgabenummer2
PublikationsstatusVeröffentlicht - 2002
Peer-Review-StatusJa

Externe IDs

PubMed 11875348
ORCID /0000-0003-3894-1175/work/148603820

Schlagworte

Schlagwörter

  • Cochlear implant, Fluoroscopy, Perimodiolar electrodes, X-ray contrast in cochlea, X-ray microscopy