Abstract
BackgroundThe inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage. In a surgically hearing preservational concept, low intracochlear pressure changes are of high importance. The aim of this study was to observe intracochlear pressure changes due to different sealing techniques in a cochlear model.MethodsCochlear implant electrode insertions were performed in an artifical cochlear model and the intracochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude of intracochlear pressure. Four different sealing conditions were compared: 1) overlay, 2) overlay with fascia pushed in, 3) donut-like fascia ring, 4) donut-like fascia ring pushed in.ResultsWe found statistically significant differences in the occurrence of maximum amplitude of intracochlear pressure peak changes related to sealing procedure comparing the different techniques. While the lowest amplitude changes could be observed for the overlay technique (0.14 mmHg ± 0.06) the highest values could be observed for the donut-like pushed in technique (1.79 mmHg ± 0.69).ConclusionSealing the electrode inserted cochlea can lead to significant intracochlear pressure changes. Pushing in of the sealing tissue cannot be recommended.
Highlights
The inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage
To avoid complications such as perilymphatic leakage, the loss of residual hearing, vertigo and ascending infections,tight sealing of the cochleostomy or the round window membrane is an important goal for Cochlear implantation (CI) surgeons
It has been shown that intracochlear pressure (ICP) changes occur during the implantationprocedure; these are relevant factors in terms of hearing preservation shown clinically and underlined experimentally
Summary
The inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage. The indications for cochlear implantation have been widened to patients with substantial residual hearing. To avoid complications such as perilymphatic leakage, the loss of residual hearing, vertigo and ascending infections,tight sealing of the cochleostomy or the round window membrane is an important goal for CI surgeons. It has been shown that speed of insertion [6], underwater insertion [7] and the size of the round window opening and moisturisation of the electrode [8] are important factors for hearing preservation
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