European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 4, pp 853–858 | Cite as

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

  • Thierry Mom
  • Aurélie Bachy
  • Aubry Houette
  • Yoann Pavier
  • Rémy Pastourel
  • Jean Gabrillargues
  • Nicolas Saroul
  • Laurent Gilain
  • Paul Avan
Otology

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 (χ2 = 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.

Keywords

Cochlear implant Round window anatomy Electrode array Insertion 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Thierry Mom
    • 1
    • 2
  • Aurélie Bachy
    • 1
  • Aubry Houette
    • 1
  • Yoann Pavier
    • 1
    • 2
  • Rémy Pastourel
    • 1
  • Jean Gabrillargues
    • 3
  • Nicolas Saroul
    • 1
  • Laurent Gilain
    • 1
    • 2
  • Paul Avan
    • 2
  1. 1.Department of Otolaryngology Head and Neck SurgeryUniversity Hospital Center CHU Gabriel Montpied, Université d’Auvergne Clermont 1Clermont-FerrandFrance
  2. 2.Laboratory of Biophysics of Sensorineureal Handicaps, Faculty of MedicineINSERM-UMR 1107, Université d’Auvergne Clermont 1Clermont-FerrandFrance
  3. 3.Department of Neuroradiology, University Hospital Center CHU Gabriel MontpiedUniversité d’Auvergne Clermont 1Clermont-FerrandFrance

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