A New Lateral Wall Electrode: Evaluation of Surgical Handling, Radiographic Placement, and Histological Appraisal of Insertion Trauma

Otol Neurotol. 2019 Jun;40(5S Suppl 1):S23-S28. doi: 10.1097/MAO.0000000000002210.

Abstract

Objective: To describe histologic and radiographic findings associated with insertion of a new lateral wall electrode in human temporal bones, as well as quantify the ease of insertion as characterized by multiple cochlear implant surgeons.

Setting: Multi-institutional cadaveric study.

Methods: The Slim J electrode was inserted in cadaveric temporal bones via a standard mastoidectomy and facial recess approach. Insertion was performed by five cochlear implant surgeons with no previous experience with the Slim J electrode array. Electrode array insertion was performed via a round window, an extended round window, or a cochleostomy approach. Intracochlear trauma, and angular insertion depth was assessed histologically and radiologically, respectively, after placement of the Slim J electrode array.

Results: Scala tympani insertion was accomplished in all 40 specimens. Thirty-eight specimens (95%) showed minimal trauma (Esrhaghi grade 0 or 1). One patient had rupture of basilar membrane (grade 2 trauma) at 380 degrees. One patient had grade 4 trauma with scalar translocation beginning at 210 degrees. The mean angular insertion depth was 416.4 degrees (range: 338.7-509.2 degrees, SD 44 degrees). Surgical handling was described as easy in 38 cases (95%).

Conclusion: In a human cadaveric model the lateral wall Slim J electrode produced minimal intracochlear trauma that was positioned completely within the scala tympani in 97.5% of cases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cadaver
  • Cochlea / surgery*
  • Cochlear Implantation / methods*
  • Cochlear Implants*
  • Humans
  • Temporal Bone / surgery