NDLI: Round window versus cochleostomy technique in cochlear implantation: histologic findings.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Richard, Céline Fayad, Jose N. Doherty, Joni Linthicum, Fred H.
Description	Country affiliation: United States Author Affiliation: Richard C ( House Research Institute, Los Angeles, California, USA.)
Abstract	HYPOTHESIS: Cochleostomy or round window enlargement techniques for cochlear implant electrode insertion result in more abnormal tissue formation in the basal cochlea and are more apt to produce endolymphatic hydrops than round window electrode insertion. METHODS: Twelve temporal bones from implanted patients were examined under light microscopy and reconstructed with 3-dimensional reconstruction software to determine cochlear damage and volume of neo-ossification and fibrosis after electrode insertion. Amount of new tissue was compared between 3 groups of bones: insertion through the round window (RW), after enlarging the RW (RWE) and cochleostomy (Cochl). The probable role of the electrode was evaluated in each case with hydrops. RESULTS: More initial damage occurred in the Cochl and RWE groups than in the RW group, and the difference was significant between RWE and RW in cochlear segment I (p < 0.026). The volume of new bone in Segment I differed significantly between groups (p < 0.012) and was greater in the RWE group than in either the Cochl or RW groups (post hoc p's < 0.035 and 0.019, respectively). Hydrops was seen in 5 cases, all in the Cochl and RWE groups. Blockage of the duct was because of new tissue formation in 4 of the 5 hydrops cases. CONCLUSION: With the electrodes in this series, implantation through the RW minimized initial intracochlear trauma and subsequent new tissue formation, whereas the RW extension technique used at the time of these implantations produced the greatest damage. Future studies may clarify whether today's techniques and electrodes will produce these same patterns of damage.
File Format	HTM / HTML
ISSN	15317129
e-ISSN	15374505
DOI	10.1097/MAO.0b013e318263d56d
Journal	Otology & Neurotology
Issue Number	7
Volume Number	33
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2012-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Adverse Effects Discipline Otolaryngology Temporal Bone Pathology Cochlear Implantation Etiology Round Window, Ear Surgery Endolymphatic Hydrops Injuries
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Sensory Systems Neurology (clinical)

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