scholarly journals Intracochlear pressure changes during CI electrode insertion - modifications for minimizing intracochlear pressure

2021 ◽  
Author(s):  
P Mittmann ◽  
R Seidl ◽  
G Lauer ◽  
A Ernst
Keyword(s):  
Electrode Insertion ◽  
Intracochlear Pressure ◽  
Pressure Changes

Minimizing Intracochlear Pressure: Influence of the Insertion Sheath

2021 ◽  
pp. 1-6
Author(s):  
Ceyhun Ucta ◽  
Philipp Mittmann ◽  
Arneborg Ernst ◽  
Rainer Seidl ◽  
Gina Lauer
Keyword(s):  
Optical Sensor ◽  
Cochlear Implantation ◽  
Apical Part ◽  
Electrode Arrays ◽  
Insertion Technique ◽  
Cochlear Model ◽  
Electrode Insertion ◽  
Intracochlear Pressure ◽  
Pressure Changes

Objective: Atraumatic cochlear implantation (CI) and insertion of the electrode in particular are major goals of recent CI surgery. Perimodiolar electrode arrays need a stylet or exosheath for insertion. The sheath can influence the intracochlear pressure changes during insertion of the electrode. The aim of this study was to modify the insertion sheath to optimize intracochlear pressure changes. Methods: In an artifical cochlear model, 7 different modified insertion sheaths were used. The intracochlear pressure was measured with a micro-optical sensor in the apical part of the model cochlea. Results: Significant lower intracochlear pressure changes were observed when the apical part of the insertion sheath was either shortened or tapered. Modification of the stopper does influence the intracochlear pressure significantly. Conclusion: Modification of the insertion sheath leads to lower intracochlear pressure gain. The differences and impact on intracochlear pressure changes found in this study underline the importance of even subtle modifications of the electrode insertion technique.

scholarly journals Intracochlear pressure changes during CI electrode insertion with the 'pullback' technique

2019 ◽  
Author(s):  
J Uçta ◽  
P Mittmann ◽  
G Lauer ◽  
R Seidl ◽  
J Wagner ◽  
...  
Keyword(s):  
Electrode Insertion ◽  
Intracochlear Pressure ◽  
Pressure Changes

scholarly journals Intracochlear Pressure Changes After Cochlea Implant Electrode Pullback—Reduction of Intracochlear Trauma

2019 ◽  
Vol 4 (4) ◽  
pp. 441-445 ◽  
Author(s):  
Gina Lauer ◽  
Julica Uçta ◽  
Lars Decker ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlea Implant ◽  
Intracochlear Pressure ◽  
Pressure Changes

scholarly journals Effect of Underwater Insertion on Intracochlear Pressure

2020 ◽  
Vol 7 ◽  
Author(s):  
Conrad Riemann ◽  
Holger Sudhoff ◽  
Ingo Todt
Keyword(s):  
Hyaluronic Acid ◽  
Cochlear Implant ◽  
Middle Ear ◽  
Round Window ◽  
Maximum Amplitude ◽  
Influential Factor ◽  
Fluid State ◽  
Insertion Techniques ◽  
Electrode Insertion ◽  
Intracochlear Pressure

Background: The importance of intracochlear pressure during cochlear electrode insertion for the preservation of residual hearing has been widely discussed. Various aspects of pre-insertional, intra-insertional, and post-insertional relevant conditions affect intracochlear pressure. The fluid situation at the round window during electrode insertion has been shown to be an influential factor.Aims/Objectives: The aim of the study was to compare various insertion techniques in terms of the fluid situation at the round window.Material and Methods: We performed insertion of cochlear implant electrodes in a curled artificial cochlear model. We placed and fixed the pressure sensor at the tip of the cochlea. In parallel to the insertions, we evaluated the maximum amplitude of intracochlear pressure under four different fluid conditions at the round window: (1) hyaluronic acid; (2) moisturized electrode, dry middle ear; (3) middle ear filled with fluid (underwater); and (4) moisturized electrode, wet middle ear, indirectly inserted.Results: We observed that the insertional intracochlear pressure is dependent on the fluid situation in front of the round window. The lowest amplitude changes were observed for the moisturized electrode indirectly inserted in a wet middle ear (0.13 mmHg ± 0.07), and the highest values were observed for insertion through hyaluronic acid in front of the round window (0.64 mmHg ± 0.31).Conclusions: The fluid state in front of the round window influences the intracochlear pressure value during cochlear implant electrode insertion in our model. Indirect insertion of a moisturized electrode through a wet middle ear experimentally generated the lowest pressure values. Hyaluronic acid in front of the round window leads to high intracochlear pressure in our non-validated artificial model.

Effects of Different Insertion Techniques of a Cochlear Implant Electrode on the Intracochlear Pressure

2016 ◽  
Vol 21 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Ingo Todt ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlear Implant ◽  
Maximum Amplitude ◽  
Cochlear Model ◽  
Pressure Peak ◽  
Insertion Techniques ◽  
Intracochlear Pressure ◽  
Pressure Changes

To achieve a functional atraumatic insertion, low intracochlear pressure changes during the procedure are assumed to be important. The aim of this study was to observe intracochlear pressure changes due to different insertion techniques in a cochlear model. Cochlear implant electrode insertions were performed in an artificial cochlear model to record intracochlear pressure changes with a micropressure sensor to evaluate the maximum amplitude and frequency of pressure changes under different insertional conditions. We found statistically significant differences in the occurrence of intracochlear pressure peak changes comparing different techniques. Based on our model results, an insertion should be maximally supported to minimize micromovement-related pressure changes.

scholarly journals Effects of Round Window Opening Size and Moisturized Electrodes on Intracochlear Pressure Related to the Insertion of a Cochlear Implant Electrode

2016 ◽  
Vol 6 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Ingo Todt ◽  
Arneborg Ernst ◽  
Philipp Mittmann
Keyword(s):  
Cochlear Implant ◽  
Round Window ◽  
Pressure Change ◽  
Hearing Preservation ◽  
Round Window Membrane ◽  
Cochlear Model ◽  
Window Opening ◽  
Hydrophilic Character ◽  
Intracochlear Pressure ◽  
Pressure Changes

Intracochlear pressure changes during the cochlear implant insertion are assumed to be an important contributor to hearing preservation. The aim was to observe intracochlear pressure changes by different round window opening sizes and different hydrophilic electrode conditions. The experiments were performed in a cochlear model with a micropressure sensor in the helicotrema area. Different artificial round window membrane and different moisturized electrode conditions were compared. A punctured round window causes a significantly higher and an indirect moisturized electrode condition a significantly lower intracochlear pressure change. The degree of round window opening and the hydrophilic character of an electrode during insertion affect the intracochlear pressure significantly in a model.

Dynamic intracochlear pressure measurement during cochlear implant electrode insertion

2019 ◽  
Vol 139 (10) ◽  
pp. 860-865 ◽  
Author(s):  
F. Ordonez ◽  
C. Riemann ◽  
S. Mueller ◽  
H. Sudhoff ◽  
I. Todt
Keyword(s):  
Cochlear Implant ◽  
Pressure Measurement ◽  
Electrode Insertion ◽  
Intracochlear Pressure
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