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Cochlear implantation through the round window with a straight slotted electrode array: optimizing the surgical procedure

  • Otology
  • Published:
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Abstract

The question addressed here is how optimizing the quality of insertion through the round window with the lower morbidity, when using a straight and slotted electrode array of regular length. This retrospective analysis includes all cases implanted with a cochlear implant Digisonic SP (Neurelec-Oticon Medical) since 2004. We checked the operative charts, the depth of insertion, and the follow-up. For comparisons, contingency tables were used and a Chi-square test was performed. A p value <0.05 was considered significant. 126 cases of patients with non-malformed cochleas were implanted through the round window. The mean age was 53.8 ± 16.2 for adults and 3.6 ± 2.6 for children (24 cases). The mean follow-up was 33 ± 22 months. The straight electrode array had either a square or a soft pointed tip (n = 84). Full insertion was achieved in 79 out of 84 cases with a soft tip vs. 18 out of 42 square tips (χ 2 = 41.41, DOF = 1, p < 0.0001). Two cases were stuck at the round window niche by a prominent crista fenestrae. In all cases but one, the chorda tympany was preserved. In one case, a misrouting to the vestibule required a revision surgery. Implantation through the round window with a straight and slotted electrode array with a soft tip (Digisonic SP, Neurelec-Oticon Medical) can lead to a full insertion in 94 % of cases. Drilling out a prominent crista fenestrae is recommended.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, University Hospital Center CHU Gabriel Montpied, Université d’Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France

    Thierry Mom, Aurélie Bachy, Aubry Houette, Yoann Pavier, Rémy Pastourel, Nicolas Saroul & Laurent Gilain

  2. Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of Medicine, INSERM-UMR 1107, Université d’Auvergne Clermont 1, Clermont-Ferrand, France

    Thierry Mom, Yoann Pavier, Laurent Gilain & Paul Avan

  3. Department of Neuroradiology, University Hospital Center CHU Gabriel Montpied, Université d’Auvergne Clermont 1, 30 place Henri Dunant, 63000, Clermont-Ferrand, France

    Jean Gabrillargues

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  1. Thierry Mom
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  2. Aurélie Bachy
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  3. Aubry Houette
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  4. Yoann Pavier
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  5. Rémy Pastourel
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  6. Jean Gabrillargues
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  7. Nicolas Saroul
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  8. Laurent Gilain
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Correspondence to Thierry Mom.

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Mom, T., Bachy, A., Houette, A. et al. Cochlear implantation through the round window with a straight slotted electrode array: optimizing the surgical procedure. Eur Arch Otorhinolaryngol 273, 853–858 (2016). https://doi.org/10.1007/s00405-015-3623-8

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  • DOI: https://doi.org/10.1007/s00405-015-3623-8

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