Forces and trauma associated with minimally invasive image-guided cochlear implantation

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Rohani, P.; Pile, J.; Kahrs, L.A.; Balachandran, R.; Blachon, G.S. et al.: Forces and trauma associated with minimally invasive image-guided cochlear implantation. In: Otolaryngology - Head and Neck Surgery 150 (2014), Nr. 4, S. 638-645. DOI: https://doi.org/10.1177/0194599813519747

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To cite the version in the repository, please use this identifier: https://doi.org/10.15488/2315

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Sum total of downloads: 80




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Abstract: 
Objective. Minimally invasive image-guided cochlear implantation (CI) utilizes a patient-customized microstereotactic frame to access the cochlea via a single drill-pass. We investigate the average force and trauma associated with the insertion of lateral wall CI electrodes using this technique. Study Design. Assessment using cadaveric temporal bones. Setting. Laboratory setup. Subjects and Methods. Microstereotactic frames for 6 fresh cadaveric temporal bones were built using CT scans to determine an optimal drill path following which drilling was performed. CI electrodes were inserted using surgical forceps to manually advance the CI electrode array, via the drilled tunnel, into the cochlea. Forces were recorded using a 6-axis load sensor placed under the temporal bone during the insertion of lateral wall electrode arrays (2 each of Nucleus CI422, MED-EL standard, and modified MED-EL electrodes with stiffeners). Tissue histology was performed by microdissection of the otic capsule and apical photo documentation of electrode position and intracochlear tissue. Results. After drilling, CT scanning demonstrated successful access to cochlea in all 6 bones. Average insertion forces ranged from 0.009 to 0.078 N. Peak forces were in the range of 0.056 to 0.469 N. Tissue histology showed complete scala tympani insertion in 5 specimens and scala vestibuli insertion in the remaining specimen with depth of insertion ranging from 360° to 600°. No intracochlear trauma was identified. Conclusion. The use of lateral wall electrodes with the minimally invasive image-guided CI approach was associated with insertion forces comparable to traditional CI surgery. Deep insertions were obtained without identifiable trauma. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.
License of this version: Es gilt deutsches Urheberrecht. Das Dokument darf zum eigenen Gebrauch kostenfrei genutzt, aber nicht im Internet bereitgestellt oder an Außenstehende weitergegeben werden. Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
Document Type: article
Publishing status: publishedVersion
Issue Date: 2014
Appears in Collections:Fakultät für Maschinenbau

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1 image of flag of Germany Germany 77 96.25%
2 image of flag of Italy Italy 1 1.25%
3 image of flag of United Kingdom United Kingdom 1 1.25%
4 image of flag of Algeria Algeria 1 1.25%

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