Abstract
Hypothesis. This study aimed to evaluate whether there is a difference in the degree of intracochlear trauma when the cochlear implant electrode arrays is inserted through different quadrants of the round window membrane. Background. The benefits of residual hearing preservation in cochlear implant recipients have promoted the development of atraumatic surgeries. Minimal trauma during electrode insertion is crucial for residual hearing preservation. Methods. In total, 25 fresh human temporal bones were subjected to mastoidectomy and posterior tympanotomy. The cochlear implant electrode array was inserted through the anterosuperior quadrant of the round window membrane in 50% of the bones and through the anteroinferior quadrant in the remaining 50%. The temporal bones were dehydrated, embedded in epoxy, serially polished, stained, viewed through a stereomicroscope, and photographed with the electrode arrays in situ. The resulting images were analyzed for signs of intracochlear trauma. Results. Histological examinations revealed varying degrees of damage to the intracochlear structures, although the incidence and severity of intracochlear trauma were not influenced by the quadrant of insertion. Conclusions. The incidence and severity of intracochlear trauma were similar in all samples, irrespective of electrode array insertion through the anterosuperior or anteroinferior quadrant of the round window membrane.
Highlights
Cochlear implants (CIs) represent a well-established treatment for severe and profound bilateral hearing loss
To avoid divergence in relation to the laterality of the ears, the samples were first divided into two groups corresponding to the right and left ears. They were randomly assigned to group 1, wherein the electrode array was inserted through the anterosuperior quadrant of the round window (RW) membrane, or group 2, wherein the electrode array was inserted through the anteroinferior quadrant
The present study demonstrated a similar degree of intracochlear trauma when CI electrode arrays were inserted through the anterosuperior and anteroinferior quadrants of the RW membrane
Summary
Cochlear implants (CIs) represent a well-established treatment for severe and profound bilateral hearing loss. The development of CIs in the last 30 years is considered one of the milestones of modern medicine, and, to date, the outcomes of CIs have been remarkable and superior to those of any other type of neural prosthesis [1]. These results have encouraged the expansion of the selection criteria for CIs [2]. Intracochlear trauma during CI-related surgical interventions is one of the factors associated with residual hearing loss [3,4,5]. Previous studies have highlighted the possibility of electrode array insertion using atraumatic surgical techniques, which have been designated as soft surgeries [4, 6,7,8,9]
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