Round Window Insertion of Precurved Electrodes Is Traumatic
Round Window Insertion of Precurved Electrodes Is Traumatic
复制标题
圆窗插入预弯曲电极会造成创伤
作者：
A. Jeyakumar;Sarah Peña;T. Brickman
目的通过调整耳蜗造口或圆窗插入位置和预成型电极阵列的大小来评估耳蜗内损伤。研究设计尸体颞骨研究。方法耳蜗电极置入位置：1）圆窗，2）圆窗前下，3）圆窗龛前下，4）圆窗龛上级。使用了两种类型的电极阵列：较大的预轮廓电极和较薄的预弯曲研究电极。组织切片由设盲的第三方制作。结果14块骨被纳入研究。6例（42.8%）为右耳。7块骨无耳蜗内损伤。七块骨头有颅内损伤。圆窗插入有较高的颅内创伤发生率与预成型电极（3/4骨）。电极置入的上级耳蜗造口有明显的耳蜗内损伤（2/2骨）。在圆窗瓣环前方下方进行的插入有50%的颅内创伤发生率（2/4骨）。通过传统的耳蜗造口（4/4的骨头）插入时没有观察到耳蜗内创伤。使用较薄电极观察到的耳蜗内创伤较少：57%，而使用较大电极阵列观察到的耳蜗内创伤为42%。使用较薄的电极阵列（2/7电极）观察到头端折叠的发生率较高。在较大电极中未观察到头端折叠。结论传统耳蜗造口术的耳蜗损伤发生率最低。较小的电极阵列对耳蜗内创伤的发生率没有显著影响，但较薄的阵列具有较高的尖端折叠发生率，这导致远端创伤。证据等级2C。
Objective Assess endocochlear trauma by adjusting: 1) location of cochleostomy or round window insertion, and 2) size of precontoured electrode array. Study Design Cadaveric temporal bone study. Methods Locations of electrode placement into the cochlea were as follows: 1) round window, 2) anterior inferior to the round window, 3) anterior inferior to the round window niche, 4) superior to the round window niche. Two types of electrode arrays were used: a larger precontoured electrode and thinner precurved research electrode. Histologic sections were made by a blinded third party. Results Fourteen bones were included in the study. Six (42.8%) of the bones were right ears. Seven bones had no endocochlear trauma. Seven bones have intracochlear trauma. Round window insertions had a high incidence of intracochlear trauma with precontoured electrodes (3/4 bones). Superior cochleostomies with electrode placement had significant intracochlear trauma (2/2 bones). Insertions made anterior inferior to the round window annulus had a 50% incidence of intracochlear trauma (2/4 bones). No endocochlear trauma observed for insertions through traditional cochleostomies (4/4 bones). Less endocochlear trauma was observed with the thinner electrode: 57% versus 42% in the larger electrode array. A higher incidence of tip fold-over was observed with the thinner electrode array (2/7 electrodes). No tip fold-over was noted in the larger electrode. Conclusion The traditional cochleostomy had the least incidence of endocochlear trauma. The smaller electrode array did not significantly affect the incidence of endocochlear trauma, but the thinner array had a higher incidence of tip fold-over, which caused trauma distally. Level of Evidence 2C.
影响因子：
3.4
作者：
Nadol, JB
通讯作者：
Nadol, JB