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Electrophysiological detection of electrode fold-over in perimodiolar cochlear implant electrode arrays: a multi-center study case series

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

It is important for the surgeon to determine the position of the CI electrode array during and after its placement within the cochlea. Most preferably, this should be within the scala tympani to obtain the best audiological outcome. Thus, misplacement into the scala vestibuli or tip fold-over should be prevented. Since there are different ways to ensure proper positioning of the electrode array within the scala tympani (e.g., intraoperative radiography, electrophysiological recordings), our study was aimed at detecting intraoperative electrophysiologic characteristics to better understand the mechanisms of those electrode tip fold-overs.

Material and methods

In a multi-centric, retrospective case–control series, patients with a postoperatively by radiography detected tip fold-over in perimodiolar electrodes were included. The point of fold-over (i.e., the electrode position) was determined and the intraoperative Auto-NRT recordings were analysed and evaluated.

Results

Four patients were found to have an electrode tip fold-over (out of 85 implantees). Significant changes of the Auto-NRT recordings were not detected. All tip fold-overs occurred in the most apical part of the electrodes.

Discussion

Cochlear implantation for hearing impaired patients plays a decisive role in modern auditory rehabilitation. Perimodiolar electrode arrays may fold over during the insertion and, hence, could have a negative impact on audiological outcome. Characteristic electrophysiologic changes to possibly predict this were not found in our series.

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Authors and Affiliations

  1. Department of Otolaryngology At Ukb, Unfallkrankenhaus Berlin, Warener Str.7, 12683, Berlin, Germany

    P. Mittmann, G. Lauer & A. Ernst

  2. Department of Radiology, Ukb Berlin, Berlin, Germany

    S. Mutze

  3. Department of Otolaryngology, Head and Neck Surgery, University of Freiburg, Freiburg, Germany

    F. Hassepass & S. Arndt

  4. Department of Otolaryngology, Head and Neck Surgery, University Hospital of Essen, University Duisburg-Essen, Essen, Germany

    D. Arweiler-Harbeck & F. Christov

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  1. P. Mittmann
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  2. G. Lauer
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  3. A. Ernst
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  4. S. Mutze
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Correspondence to P. Mittmann.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (IRB-ukb-HNO-2018/01) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Mittmann, P., Lauer, G., Ernst, A. et al. Electrophysiological detection of electrode fold-over in perimodiolar cochlear implant electrode arrays: a multi-center study case series. Eur Arch Otorhinolaryngol 277, 31–35 (2020). https://doi.org/10.1007/s00405-019-05653-9

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