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Insertionsergebnisse von Contour™- und Contour-Advance™-Elektroden

Gibt es individuelle Lernkurven?

Insertion results for Contour™ and Contour Advance™ electrodes

Are there individual learning curves?

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Zusammenfassung

Ziel der Untersuchung war die Evaluation der Insertionsergebnisse nach Cochleaimplantation von Contour™- und Contour-Advance™-Elektrodenträgern bei erwachsenen Patienten sowie die Verfolgung der individuellen Insertionsergebnisse dreier erfahrener Chirurgen. Anhand der routinemäßig durchgeführten postoperativen 3-D-Volumentomographie bei 223 erwachsenen Patienten mit Lagebestimmung der Elektrode in der Cochlea (Scala tympani, Scala vestibuli, Dislokation von einer in die andere Scala). wurde retrospektiv das chirurgische Vorgehen analysiert und den jeweiligen Chirurgen zugeordnet. Die Scala-tympani-Insertionen stiegen von initial 33 auf 84% signifikant an. Mit Verwendung der Contour-Advance™-Elektrode sank gleichzeitig die Dislokationsrate aus der Scala tympani in die Scala vestibuli von initial 71% mit der Contour™-Elektrode auf 22%. Für die einzelnen Chirurgen zeigten sich individuelle Unterschiede in Bezug auf die Scala-tympani-Insertionsraten und die Dislokationsraten im Untersuchungszeitraum. Mit der 3-D-Volumentomographie ließ sich die Elektrodenposition in allen Fällen evaluieren, sodass ein wertvolles Instrument zur Qualitätskontrolle vorliegt. Gleichzeitig stellten sich individuelle Lernkurven dar. Die Kontrolle der Insertionsqualität ist notwendig, um durch ein Feedback der Insertionsergebnisse die chirurgische Qualität verbessern zu helfen und konsekutiv die Rehabilitationsergebnisse zu verbessern.

Abstract

The aim of our study was to evaluate results of insertion following cochlear implantation with Contour™ and Contour Advance™ electrode arrays in adult patients and to analyze individual insertion results for three experienced surgeons. We performed a retrospective analysis of postoperative 3D volume tomography results in 223 adult patients. The intracochlear electrode position was evaluated to be in scala tympani, scala vestibuli or with a dislocation from one scala to the other. Surgical methods were analyzed and assigned to the different surgeons. We observed a significant increase for scala tympani insertions from initially 33% to 84% and a reduction in dislocations from scala tympani to scala vestibuli from 71% with the Contour™ electrode to 22% with the Contour Advance™ electrode. Results for the different surgeons varied individually with regard to scala tympani insertion rates and dislocation rates over time. 3D Volume tomography offers an important method for postoperative quality control following cochlear implant surgery. The intracochlear electrode position could be determined in all cases. We were able to identify individual learning curves for insertion results. Controlling the insertion quality serves as a feedback of surgical results and may be helpful for improving surgical quality and thus rehabilitation results.

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Authors and Affiliations

  1. Univ.-HNO-Klinik und Implant Centrum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland

    A. Aschendorff, S. Arndt, R. Beck, C. Schild, L. Röddiger, W. Maier & R. Laszig

  2. Univ.-HNO-Klinik Düsseldorf, Düsseldorf, Deutschland

    T. Klenzner

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  1. A. Aschendorff
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  2. T. Klenzner
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  3. S. Arndt
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  4. R. Beck
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  5. C. Schild
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  6. L. Röddiger
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  7. W. Maier
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  8. R. Laszig
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Correspondence to A. Aschendorff.

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Aschendorff, A., Klenzner, T., Arndt, S. et al. Insertionsergebnisse von Contour™- und Contour-Advance™-Elektroden. HNO 59, 448–452 (2011). https://doi.org/10.1007/s00106-011-2319-7

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  • DOI: https://doi.org/10.1007/s00106-011-2319-7

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