Abstract
To preserve residual hearing in cochlea implantation, the electrode design has been refined and an atraumatic insertion of the cochlea electrode has become one aspect of cochlea implant research. The opening of the round window can be assumed to be a contributing factor in an atraumatic concept. The aim of our study was to observe intracochlear pressure changes due to different opening conditions of an artificial round window membrane. The experiments were performed in an artificial cochlea model. A round window was simulated with a polythene foil and a pressure sensor was placed in the helicotrema area to monitor intraluminal pressure changes. Openings of the artificial round window membrane were performed using different ways. Opening the artificial round window mechanically showed a biphasic behaviour of pressure change. Laser openings showed a unidirectional pressure change. The lowest pressure changes were observed when opening the artificial round window membrane using a diode laser. The highest pressure changes were seen when using a needle. The openings with the CO2 laser showed a negative intracochlear pressure and a loss of fluid. In our model experiments, we could prove that the opening of the artificial round window membrane causes various intracochlear pressure changes.
Highlights
The indication criteria for cochlea implantation have changed over the past decades to patients with residual hearing
A round window was simulated with a polythene foil and a pressure sensor was placed in the helicotrema area to monitor intraluminal pressure changes
The insertion trauma is assumed to depend on different factors, and the contribution of each factor is unclear to some degree: the way and degree of opening the cochlea, insertion of the electrode array, additional medication [7], sealing of the cochlea, and the electrode design
Summary
The indication criteria for cochlea implantation have changed over the past decades to patients with residual hearing. As the criteria for cochlea implantation evolved, the perioperative surroundings, electrode design, and surgical technique have developed as well. Common surgical sense is that a selective scala tympani insertion should be achieved [1] and the insertion trauma should be minimised [2,3,4,5,6]. The two major surgical techniques for access to the cochlea have been the round window approach and the “soft surgery” cochleostomy [8]. The anatomical conditions make it mandatory to drill away the promontorial lip to overlook the round window membrane [9], but the opening procedure itself has not been further evaluated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
