Optimal cochlear implant insertion vectors

Xenia Meshik, Timothy A. Holden, Richard A. Chole, Timothy Hullar

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Hypothesis: An optimal insertion trajectory during cochlear implantation may be determined from the anatomic relationship between the facial nerve and round window. Background: Cochlear implantation functional outcomes improve with insertion of the implant into the scala tympani. This depends on creating a cochleostomy in the proper position and inserting the electrode along a trajectory coaxial with the centerline of the scala tympani. The anatomic landmarks for this insertion trajectory have not been described. METHODS:: Clinical computed tomography and micro-computed tomographic analysis of 8 cadaveric temporal bones. Results: Appropriate insertion vectors pass inferior or anteroinferior to the round window membrane. In many individuals, the facial nerve interrupts all or most of the insertion vectors coaxial to the centerline of the scala tympani. Conclusion:: A cochleostomy placed inferior or anteroinferior to the round window membrane may facilitate atraumatic insertion of a cochlear implant along the centerline of the scala tympani. The lateral and anterior wall of the fallopian canal must be adequately thinned to achieve an optimal insertion trajectory. This is particularly true when inserting through cochleostomies placed away from the round window along the basal turn of the cochlea.

Original languageEnglish (US)
Pages (from-to)58-63
Number of pages6
JournalOtology and Neurotology
Volume31
Issue number1
DOIs
StatePublished - Jan 2010
Externally publishedYes

Fingerprint

Scala Tympani
Cochlear Implants
Cochlear Implantation
Facial Nerve
Anatomic Landmarks
Membranes
Temporal Bone
Cochlea
Electrodes
Tomography

Keywords

  • Cochlear implant
  • Cochleostomy
  • Facial nerve

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

Optimal cochlear implant insertion vectors. / Meshik, Xenia; Holden, Timothy A.; Chole, Richard A.; Hullar, Timothy.

In: Otology and Neurotology, Vol. 31, No. 1, 01.2010, p. 58-63.

Research output: Contribution to journalArticle

Meshik, Xenia ; Holden, Timothy A. ; Chole, Richard A. ; Hullar, Timothy. / Optimal cochlear implant insertion vectors. In: Otology and Neurotology. 2010 ; Vol. 31, No. 1. pp. 58-63.
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