Cochleostomy site: Implications for electrode placement and hearing preservation
Cochleostomy site: Implications for electrode placement and hearing preservation
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DOI：
10.1080/00016480510031489
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发表时间：
2005-08-01
影响因子：
1.4
通讯作者：
Roberson, JB
中科院分区：
文献类型：
--
作者：
Briggs, RJS;Tykocinski, M;Roberson, JB
结论。随着近年来人们对在人工耳蜗植入过程中减少耳蜗内损伤和保留残余听力的兴趣的增加，必须增加对耳蜗造口部位的关注。本文的结果表明，耳蜗造口必须位于圆形窗口的下方，而不是前面，以确保鼓膜的插入，并减少电极插入过程中插入引起耳蜗内损伤的可能性。目标。描述耳蜗钩区复杂的解剖结构，特别是与耳蜗造口术的最佳位置有关的人工耳蜗电极插入，以潜在地实现听力保护。作者认为，以前的行业建议和描述的手术技术导致耳蜗造口放置在解剖位置，可能导致电极插入，损害基底膜和/或其他耳蜗结构。材料和方法。本文综述了颞骨的一些研究成果，重点讨论了基底膜和螺旋韧带与圆窗膜的解剖关系。对于不同的耳蜗造口部位，评估了对耳蜗内结构，特别是基底膜和Corti器官的潜在损害。结果。对人类颞骨电极插入研究的回顾，以及对植入颞骨的尸检解剖研究表明，当耳蜗造口术在圆窗前方进行时，前庭鳞片插入和插入引起的耳蜗内结构损伤的风险增加。这些结果得到了详细解剖耳蜗钩区研究的支持。
Conclusions. With recent increased interest in minimizing intracochlear trauma and preserving residual hearing during cochlear implantation, increased attention must be paid to the cochleostomy site. The results of this paper demonstrate that the cochleostomy must be made inferior, rather than anterior, to the round window to ensure scala tympani insertion and to decrease the likelihood of insertion-induced intracochlear damage during electrode insertion. Objective. To describe the complex anatomy of the hook region of the cochlea, specifically in relation to the optimal placement of the cochleostomy for cochlear implant electrode insertion to potentially achieve hearing preservation. The authors believe that previous industry recommendations and described surgical techniques have resulted in cochleostomies being placed in anatomical positions that possibly result in electrode insertions that damage the basilar membrane and/or other cochlear structures. Material and methods. The results of a number of temporal bone studies were reviewed with attention being paid to the anatomical relationship of the basilar membrane and spiral ligament to the round window membrane. For different cochleostomy sites the potential for damage to intracochlear structures, particularly the basilar membrane and organ of Corti, was assessed. Results. The review of electrode insertion studies into human temporal bones, as well as a post-mortem anatomical study of implanted temporal bones, showed an increased risk of scala vestibuli insertions and insertion-induced damage to intracochlear structures when the cochleostomy was performed more anterior to the round window. These results were endorsed by studies detailing the anatomy of the hook region of the cochlea.