665 results match your criteria Cochlear Implants Surgical Technique

Remote Intraoperative Neural Response Telemetry: Technique and Results in Cochlear Implant Surgery.

Otol Neurotol 2022 Jul;43(6):638-642

Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California.

Objective: Present results with remote intraoperative neural response telemetry (NRT) during cochlear implantation (CI) and its usefulness in overcoming the inefficiency of in person NRT.

Study Design: Case series.

Setting: Tertiary academic otology practice. Read More

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Fluorescence hybridization and microbial community profiling analysis of explanted cochlear implants.

Acta Otolaryngol 2022 May 12;142(5):395-401. Epub 2022 May 12.

Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York City, NY, USA.

Background: Cochlear implant (CI) infections affect a small, but significant number of patients. Unremitting infections can lead to explantation. Fluorescence hybridization (FISH) and microbial community profiling (MCP) are methods of studying microbial environments of explanted devices that can provide information to reduce morbidity and costs of infected CIs. Read More

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Emerging therapies for human hearing loss.

Expert Opin Biol Ther 2022 Jun 11;22(6):689-705. Epub 2022 May 11.

Bionics Institute, East Melbourne, Victoria, Australia.

Introduction: More than 5% of the world's population have a disabling hearing loss which can be managed by hearing aids or implanted electrical devices. However, outcomes are highly variable, and the sound perceived by recipients is far from perfect. Sparked by the discovery of progenitor cells in the cochlea and rapid progress in drug delivery to the cochlea, biological and pharmaceutical therapies are currently in development to improve the function of the cochlear implant or eliminate the need for it altogether. Read More

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Clinical experiences with intraoperative electrocochleography in cochlear implant recipients and its potential to reduce insertion trauma and improve postoperative hearing preservation.

PLoS One 2022 22;17(4):e0266077. Epub 2022 Apr 22.

Department of Otolaryngology, Hannover Medical School, Hannover, Germany.

Access to low-frequency acoustic information in cochlear implant patients leads to better speech understanding in noise. Electrocochleography (ECochG) can provide real-time feedback about the health of the cochlea during the insertion process with the potential to reduce insertion trauma. We describe our experiences of using this technique. Read More

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Recording EEG in cochlear implant users: Guidelines for experimental design and data analysis for optimizing signal quality and minimizing artifacts.

J Neurosci Methods 2022 Jun 30;375:109592. Epub 2022 Mar 30.

International Laboratory for Brain, Music & Sound Research, Montreal, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Canada; Centre for Research on Brain, Language & Music, Montreal, Canada.

Cochlear implants (CI) are neural prostheses that can restore hearing in individuals with severe to profound hearing loss. Although CIs significantly improve quality of life, clinical outcomes are still highly variable. An important part of this variability is explained by the brain reorganization following cochlear implantation. Read More

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Variations in microanatomy of the human modiolus require individualized cochlear implantation.

Sci Rep 2022 03 23;12(1):5047. Epub 2022 Mar 23.

Department of Otolaryngology, Hannover Medical School, Hannover, Germany.

Cochlear variability is of key importance for the clinical use of cochlear implants, the most successful neuroprosthetic device that is surgically placed into the cochlear scala tympani. Despite extensive literature on human cochlear variability, few information is available on the variability of the modiolar wall. In the present study, we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies (CTs) and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Read More

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Variability in surgical techniques for cochlear implantation: an international survey study.

Cochlear Implants Int 2022 07 22;23(4):195-202. Epub 2022 Mar 22.

Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Objective: This study aimed to gain insight into current practices regarding the surgical techniques used for positioning and fixation of internal components of the cochlear implant.

Methods: A questionnaire focused on surgical techniques used for cochlear implantation was distributed among 441 cochlear implant surgeons. Descriptive statistics were reported. Read More

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Stimulating the Cochlear Apex Without Longer Electrodes: Preliminary Results With a New Approach.

Otol Neurotol 2022 06 10;43(5):e578-e581. Epub 2022 Mar 10.

Department of Otolaryngology, New York University Grossman School of Medicine, New York, New York.

Objective: To investigate a new surgical and signal processing technique that provides apical stimulation of the cochlea using a cochlear implant without extending the length of the electrode array.

Patients: Three adult patients who underwent cochlear implantation using this new technique.

Interventions: The patients received a cochlear implant. Read More

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Visual cortex plasticity in cochlear implant users revealed in a visual motion detection task.

Clin Neurophysiol 2022 05 17;137:11-24. Epub 2022 Feb 17.

International Laboratory for Brain, Music and Sound Research, Montreal, Canada; Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, Canada; Centre for Research on Brain, Language and Music, Montreal, Canada.

Objective: The aim of this study was to investigate brain reorganization following cochlear implantation using electroencephalography, an implant-compatible technique to record electrical brain activity.

Methods: We investigated cortical plasticity in cochlear implant (CI) users using visual evoked potentials in response to visual motion changes. We estimated visual and auditory neural sources in CI users (n = 20) and normal hearing (NH) matched control participants (n = 22). Read More

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American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children.

Ear Hear 2022 Mar/Apr;43(2):268-282

Department of Speech Language Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

This article summarizes the available evidence on pediatric cochlear implantation to provide current guidelines for clinical protocols and candidacy recommendations in the United States. Candidacy determination involves specification of audiologic and medical criteria per guidelines of the Food and Drug Administration. However, recommendations for a cochlear implant evaluation also should maintain flexibility and consider a child's skill progression (i. Read More

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Prolonged Insertion Time Reduces Translocation Rate of a Precurved Electrode Array in Cochlear Implantation.

Otol Neurotol 2022 04;43(4):e427-e434

Department of Otorhinolaryngology.

Hypothesis: Insertion speed during cochlear implantation determines the risk of cochlear trauma. By slowing down insertion speed tactile feedback is improved. This is highly conducive to control the course of the electrode array along the cochlear contour and prevent translocation from the scala tympani to the scala vestibuli. Read More

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Autologous fat grafting as a minimally invasive technique to avoid cochlear implant extrusion.

Cochlear Implants Int 2022 05 10;23(3):173-177. Epub 2022 Feb 10.

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Infection of the skin-muscle flap is one of the most severe risks of cochlear implantation. The aim of this paper is to describe a novel and minimally invasive procedure to avoid cochlear implant (CI) extrusion. A 79-year-old woman with severe comorbidities developed a pressure injury of the skin-muscle flap overlying the CI receiver/stimulator (R/S) nine years after surgery. Read More

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Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion: A Case Report.

JBJS Case Connect 2022 01 20;12(1). Epub 2022 Jan 20.

Penn State Hershey Medical Center, Bone and Joint Institute, Hershey, Pennsylvania.

Case: Transcranial electric stimulation motor-evoked potentials (tcMEPs) are the most sensitive technique in multimodality intraoperative neuromonitoring (IONM) for posterior spinal fusion (PSF). The presence of a cochlear implant (CI) is considered a contraindication to IONM because of theoretical risk of implant device and local tissue damage from voltages induced by tcMEPs. We present the case of a 10-year-old girl with CI who underwent successful PSF with tcMEP and monopolar electrocautery (MoEC) without perioperative complications or CI damage. Read More

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January 2022

A three-dimensional exoscope system for bilateral simultaneous cochlear implant surgery: how I do it.

J Laryngol Otol 2022 Apr 7;136(4):360-362. Epub 2022 Jan 7.

Department of Otolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: This paper reports the first case of simultaneous bilateral cochlear implant surgery performed exclusively with a three-dimensional exoscope. It also discusses the optimum operative set-up and the feasibility of three-dimensional exoscopic ear surgery as an alternative to the microscope.

Method: The Vitom three-dimensional exoscope system (Karl Storz) was used. Read More

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Robotics, automation, active electrode arrays, and new devices for cochlear implantation: A contemporary review.

Hear Res 2022 02 25;414:108425. Epub 2021 Dec 25.

Inserm/Institut Pasteur, Institut de l'Audition, Technologie et Thérapie Génique de la Surdité, Paris, France; Sorbonne Université/AP-HP, GHU Pitié-Salpêtrière, DMU ChIR, Service ORL, GRC Robotique et Innovation Chirurgicale, Paris, France.

In the last two decades, cochlear implant surgery has evolved into a minimally invasive, hearing preservation surgical technique. The devices used during surgery have benefited from technological advances that have allowed modification and possible improvement of the surgical technique. Robotics has recently gained popularity in otology as an effective tool to overcome the surgeon's limitations such as tremor, drift and accurate force control feedback in laboratory testing. Read More

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February 2022

Cochlear implantation: Exploring the effects of 3D stereovision in a digital microscope for virtual reality simulation training - A randomized controlled trial.

Cochlear Implants Int 2022 Mar 1;23(2):80-86. Epub 2021 Dec 1.

Copenhagen Hearing and Balance Center, Department of Otorhinolaryngology Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.

In cochlear implantation (CI), excellent surgical technique is critical for hearing outcomes. Recent advances in temporal bone Virtual Reality (VR) training allow for specific training of CI and through introduction of new digital microscopes with ultra-high-fidelity (UHF) graphics. This study aims to investigate whether UHF increases performance in VR simulation training of CI electrode insertion compared with conventional, screen-based VR (cVR). Read More

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Reliability of CIR-S using the subperiosteal pocket technique under 2 years of age.

Cochlear Implants Int 2022 Mar 1;23(2):109-113. Epub 2021 Dec 1.

Department of Otorhinolaryngology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.

Objective: It is aimed in this study to investigate the reliability of the cochlear implant receiver-stimulator (CIR-S) placement using unfixed subperiosteal tight pocket technique and the postoperative soft tissue changes that occur around the CIR-S, in toddlers under 2 years of age.

Methods: Nonsyndromic toddlers with normal radiological findings and who were planned to have cochlear implantation were included in the study. Preoperative and postoperative complications, device migration, and postoperative soft tissue changes occurred around the CIR were analyzed using objective methods. Read More

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Measurement and Mitigation of Intracochlear Pressure Transients During Cochlear Implant Electrode Insertion.

Otol Neurotol 2022 02;43(2):174-182

Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado.

Hypothesis: High intracochlear pressure transients associated with cochlear implant placement are reduced with smaller, non-styleted arrays, and longer insertion durations.

Background: With increasing focus on hearing preservation during cochlear implant surgery, atraumatic technique is of the utmost importance. Previous studies revealed that high intensity pressure transients can be generated during the insertion of implant electrodes. Read More

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February 2022

Combined Endoscopic/Microscopic Cochlear Implantation Through the Oval Window.

Italo Cantore

J Audiol Otol 2022 Apr 9;26(2):103-107. Epub 2021 Nov 9.

Cochlear Implants Regional Center, San Carlo Regional Hospital, Potenza, Italy.

Standard round window (RW) cochlear implantation is a well-described technique. Implantation might be difficult in patients with inner and middle ear anomalies, in some cases because of not achieving adequate exposure to the RW, with a related higher risk of complications such as facial nerve injury. It is proposed a combined microscopic/endoscopic oval window approach in a 63 year old man affected by bilateral Menière disease, with bilateral severe sensorineural hearing loss, speech discrimination score for bysillabic words under 40% and a hidden RW by anomalous facial nerve course. Read More

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Salvaging Exposed Cochlear Implants.

Plast Reconstr Surg Glob Open 2021 Oct 28;9(10):e3899. Epub 2021 Oct 28.

Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

The cochlear implant (CI) procedure is one of the most efficient surgical options for the management of patients suffering from severe bilateral sensorineural hearing loss. Notably, CI exposure is one of the most commonly reported complications. Herein, we report our experience in the management of three patients with CIs complicated by implant exposure. Read More

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October 2021

[The application progress of cone beam computed tomography in cochlear implantation].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Sep;35(9):845-849

Cochlear implantation has become the primary treatment of choice for the patients with severe or profound sensorineural hearing loss. However, the outcomes of cochlear implantation are affected by many factors which need multi-disciplinary evaluation such as imaging, audiology and linguistics. Cone beam computed tomography, a novel imaging technique, has been increasingly used in the study of cochlear morphology, accurate location of electrode and evaluation of inner ear trauma after cochlear implantation. Read More

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September 2021

Histopathologic Analysis of Temporal Bones With Otosclerosis Following Cochlear Implantation.

Otol Neurotol 2021 12;42(10):1492-1498

Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.

Objective: Analyze changes in osteoneogenesis and fibrosis following cochlear implant (CI) surgery in patients with otosclerosis and compare differences based on insertion technique.

Background: When advanced otosclerotic disease extends to the otic capsule, severe and profound sensorineural hearing loss necessitates consideration of a cochlear implant. Histopathological analysis of the human temporal bone after implantation in the patient with otosclerosis may reveal important variables that predict CI success. Read More

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December 2021

Unifying information theory and machine learning in a model of electrode discrimination in cochlear implants.

PLoS One 2021 20;16(9):e0257568. Epub 2021 Sep 20.

Computational Learning Systems Laboratory, School of Information Technology & Mathematical Sciences, University of South Australia, Mawson Lakes, SA, Australia.

Despite the development and success of cochlear implants over several decades, wide inter-subject variability in speech perception is reported. This suggests that cochlear implant user-dependent factors limit speech perception at the individual level. Clinical studies have demonstrated the importance of the number, placement, and insertion depths of electrodes on speech recognition abilities. Read More

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November 2021

Pharmacological, surgical and diagnostic innovations in Meniere's disease: a review.

Transl Med UniSa 2020 Sep 1;23:48-52. Epub 2020 Oct 1.

Surgical Sciences Department, University of Turin, Turin, Italy.

Meniere's disease is an inner ear disorder characterized by the presence of endolymphatic hydrops in the inner ear and symptomatology of recurrent and debilitating vertigo attacks, tinnitus, aural fullness, and fluctuating sensorineural hearing loss. Although many therapeutic options for MD have been proposed during years, no consensus has been reached by the scientific community. In the last decade, many therapeutic options have been proposed, as intratympanic steroid, intratympanic gentamicin, and intravenous glycerol. Read More

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September 2020

[Effect of electrode array type and insertion technique on the insertion force: in vitro cochlear model study].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Jul;56(7):691-697

Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200125, China.

To investigate the effect of insertion technique and electrode array type on the insertion force of electrode array, and to provide a basis for further optimizing electrode design and facilitating mini-invasive electrode insertion. Three types of electrode array from Nurotron (Standard Electrode, Slim-medium Electrode, Slim-long Electrode) were studied. from July 2019 to December 2019. Read More

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Endoscopy-Assisted Transmeatal Cochlear Implantation in Multiple Ear Deformities.

J Int Adv Otol 2021 Jul;17(4):376-379

Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

To study congenitally deaf children with inner ear malformations that usually have comorbid anomalous facial nerves and middle ear deformities. To determine the feasibility of endoscopy-assisted transmeatal cochlear implantation with the purpose of reducing the risks of iatrogenic facial nerve injury. This report presents a unique technique in a pediatric case with multiple ear anomalies: microtia, cochlear hypoplasia with an aberrant facial nerve, a sigmoid sinus deformity leading to a narrow mastoid cavity, and a flat promontory wall without round window. Read More

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Robot-Assisted Electrode Array Insertion Becomes Available in Pediatric Cochlear Implant Recipients: First Report and an Intra-Individual Study.

Front Surg 2021 7;8:695728. Epub 2021 Jul 7.

Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

As an advanced surgical technique to reduce trauma to the inner ear, robot-assisted electrode array (EA) insertion has been applied in adult cochlear implantation (CI) and was approved as a safe surgical procedure that could result in better outcomes. As the mastoid and temporal bones are generally smaller in children, which would increase the difficulty for robot-assisted manipulation, the clinical application of these systems for CI in children has not been reported. Given that the pediatric candidate is the main population, we aim to investigate the safety and reliability of robot-assisted techniques in pediatric cochlear implantation. Read More

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Atraumatic Insertion of a Cochlear Implant Pre-Curved Electrode Array by a Robot-Automated Alignment with the Coiling Direction of the Scala Tympani.

Audiol Neurootol 2022 20;27(2):148-155. Epub 2021 Jul 20.

Technologies et thérapie génique pour la surdité, Institut de l'Audition, Institut Pasteur/Inserm, Paris, France.

Introduction: Electrode array translocation is an unpredictable event with all types of arrays, even using a teleoperated robot in a clinical scenario. We aimed to compare the intracochlear trauma produced by the HiFocus™ Mid-Scala (MS) electrode array (Advanced Bionics, Valencia, CA, USA) using a teleoperated robot, with an automated robot connected to a navigation system to align the pre-curved tip of the electrode array with the coiling direction of the scala tympani (ST).

Methods: Fifteen freshly frozen temporal bones were implanted with the MS array using the RobOtol® (Collin, Bagneux, France). Read More

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Cochlear Implantation in Infants: Why and How.

Trends Hear 2021 Jan-Dec;25:23312165211031751

Department of Otolaryngology, Head & Neck Surgery, The 7979Hospital for Sick Children, Toronto, Ontario, Canada.

In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. Read More

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Delayed postoperative complications in 624 consecutive cochlear implantation cases.

Acta Otolaryngol 2021 Jul 6;141(7):663-670. Epub 2021 Jul 6.

Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Research Institute of Otolaryngology, Nanjing, China.

Sensorineural hearing loss can be cured by cochlear implantation (CI), but complications can occur. Based on when the complications develop, they are categorized as intraoperative complications, early postoperative complications, or delayed postoperative complications (>3 months after the surgery). We aimed to investigate the occurrence of delayed complications after CI surgery, and identify appropriate management methods. Read More

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