A New Lateral Wall Electrode: Evaluation of Surgical Handling, Radiographic Placement, and Histological Appraisal of Insertion Trauma

Alejandro Rivas, Robert J. Yawn, Ana H. Kim, Colin Driscoll, Robert Cullen, Stephen J. Rebscher, Brandon Isaacson

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To describe histologic and radiographic findings associated with insertion of a new lateral wall electrode in human temporal bones, as well as quantify the ease of insertion as characterized by multiple cochlear implant surgeons. SETTING: Multi-institutional cadaveric study. METHODS: The Slim J electrode was inserted in cadaveric temporal bones via a standard mastoidectomy and facial recess approach. Insertion was performed by five cochlear implant surgeons with no previous experience with the Slim J electrode array. Electrode array insertion was performed via a round window, an extended round window, or a cochleostomy approach. Intracochlear trauma, and angular insertion depth was assessed histologically and radiologically, respectively, after placement of the Slim J electrode array. RESULTS: Scala tympani insertion was accomplished in all 40 specimens. Thirty-eight specimens (95%) showed minimal trauma (Esrhaghi grade 0 or 1). One patient had rupture of basilar membrane (grade 2 trauma) at 380 degrees. One patient had grade 4 trauma with scalar translocation beginning at 210 degrees. The mean angular insertion depth was 416.4 degrees (range: 338.7-509.2 degrees, SD 44 degrees). Surgical handling was described as easy in 38 cases (95%). CONCLUSION: In a human cadaveric model the lateral wall Slim J electrode produced minimal intracochlear trauma that was positioned completely within the scala tympani in 97.5% of cases.

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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