Insertion trauma and functional recovery after cochlear implantation

Abstract

The cochlear implant is considered one of the most successful medical devices. The efficiency and cost-effectiveness of implants making a difference in the life of a person with hearing loss is well recognized. There are approximately 750,000 implant patients worldwide. While implant technology is advancing and clinical indications continue to expand, the focus is increasingly shifting towards improving outcomes and enhancing the quality of patient care. Of particular relevance today is the preservation of delicate intracochlear structures during implant surgery, which provides the best prerequisite for successful hearing rehabilitation. In this regard, the article is devoted to the consideration of peculiarities and methods of detection of tissue traumatization during cochlear implantation, as well as the possibilities of functional recovery after implantation. The methodological basis of the study is a systematic literature search, which was conducted using PubMed Medline, methods of analysis, synthesis, generalization, and grouping, investigation of the results of radiological and histological studies. The analysis describes the possibilities and potential of using contrast-enhanced micro-CT with simultaneous application of a special polyoxometalate staining agent to analyze cochlear implant injuries. Special attention is paid to the prospects of using a robotic surgical instrument that assists the surgeon in the insertion of the electrode array. The advantage of using the growth function of the amplitude of the evoked compound action potential to assess functional responses to electrical stimulation of the cochlea is also noted. Further studies of the geometry of intracochlear structures and compartments will allow developing new and improved electrode designs and introducing atraumatic surgical techniques for cochlear implant insertion.