Evaluation of a Slim Modiolar Electrode Array: A Temporal Bone Study.

Hypothesis: Evaluation of the Slim Modiolar (SM) electrode in temporal bones (TB) will elucidate the electrode's insertion outcomes.

Background: The SM electrode was designed for atraumatic insertion into the scala tympani, for ideal perimodiolar positioning and with a smaller caliber to minimize interference with cochlear biological processes.

Methods: The SM electrode was inserted into TBs via a cochleostomy.

Force and pressure measurements in temporal bones.

Purpose: Some cochlear implant (CI) patients lose their residual hearing during surgery. Two factors that might play a role in residual hearing loss are the change in intracochlear hydraulic pressure and force on the cochlear wall during electrode insertion. The aim of this study is to investigate whether a difference in peak hydraulic pressure and peak force on the cochlear wall exists during a CI electrode insertion with different insertion techniques.

Does cochleostomy location influence electrode trajectory and intracochlear trauma?

Objectives/hypothesis: Trauma to intracochlear structures during cochlear implant insertion is associated with poorer hearing outcomes. One way surgeons can influence insertion trauma is by choosing the surgical approach. We seek to compare cochleostomy (CO), peri-round window (PRW), and round window (RW) approaches using a fresh frozen temporal bone model.

Real-time measurement of electrode impedance during intracochlear electrode insertion.

Objectives/hypothesis: This pilot study details the use of a software tool that uses continuous impedance measurement during electrode insertion, with the eventual potential to assess and optimize electrode position and reduce insertional trauma.

Study Design: Software development and experimental study with human cadaveric cochleae and two live surgeries.

Methods: A prototype program to measure intracochlear electrode impedance and display it graphically in real time has been developed.

High-resolution cone-beam computed tomography: a potential tool to improve atraumatic electrode design and position.

Conclusions: Flat-panel cone-beam computed tomography (CBCT) is able to assess the trajectory of the implanted cochlear implant (CI) array. This is essential to determine specific effects of electrode design and surgical innovations on outcomes in cochlear implantation. CBCT is a non-invasive approach yielding similar data to histopathological analyses, with encouraging potential for use in surgical, clinical and research settings.

Radiation therapy in cochlear implant recipients.

Hypothesis: Processes of scattering and attenuation were investigated to determine the consequence on dose distributions by having a cochlear implant in the field of therapeutic radiation.

Background: Radiation oncology medical accelerator beams of 6- and 18-MV x-ray energy were used. Five cochlear implants were investigated.

The temporalis pocket technique for cochlear implantation: an anatomic and clinical study.

Objective: To describe the surgical anatomy and clinical outcomes of a technique for securing cochlear implant receiver/stimulators (R/S). Receiver/stimulators are generally secured by drilling a custom-fit seat and suture-retaining holes in the skull. However, rare intracranial complications and R/S migration have been reported with this standard method.