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Comparison of Electrode Position in the Human Cochlea Using Various Perimodiolar Electrode Arrays

Tykocinski, Michael*†; Cohen, Lawrence T.*†; Pyman, Brian C.*†; Roland, Thomas Jr.§; Treaba, Claudiu*¶; Palamara, Joseph‡; Dahm, Markus C.*†; Shepherd, Robert K.†; Xu, Jin*†; Cowan, Robert S.*†; Cohen, Noel L.§; Clark, Graeme M.*†

Cochlear Implants

Objective: This study was conducted to evaluate the insertion properties and intracochlear trajectories of three perimodiolar electrode array designs and to compare these designs with the standard Cochlear/Melbourne array.

Background: Advantages to be expected of a perimodiolar electrode array include both a reduction in stimulus thresholds and an increase in dynamic range, resulting in a more localized stimulation pattern of the spiral ganglion cells, reduced power consumption, and, therefore, longer speech processor battery life.

Methods: The test arrays were implanted into human temporal bones. Image analysis was performed on a radiograph taken after the insertion. The cochleas were then histologically processed with the electrode array in situ, and the resulting sections were subsequently assessed for position of the electrode array as well as insertion-related intracochlear damage.

Results: All perimodiolar electrode arrays were inserted deeper and showed trajectories that were generally closer to the modiolus compared with the standard electrode array. However, although the precurved array designs did not show significant insertion trauma, the method of insertion needed improvement. After insertion of the straight electrode array with positioner, signs of severe insertion trauma in the majority of implanted cochleas were found.

Conclusions: Although it was possible to position the electrode arrays close to the modiolus, none of the three perimodiolar designs investigated fulfilled satisfactorily all three criteria of being easy, safe, and atraumatic to implant.

*Cooperative Research Centre for Cochlear Implant, Speech and Hearing Research, †Department of Otolaryngology, and ‡School of Dental Science, University of Melbourne, Parkville, Victoria, Australia; §Department of Otolaryngology, New York University School of Medicine, New York, New York, U.S.A.; and ¶Cochlear Ltd. Pty, Lane Cove, New South Wales, Australia.

Supported in part by the Cooperative Research Centre for Cochlear Implant, Speech and Hearing Research.

Address correspondence and reprint requests to Dr. Michael Tykocinski, Department of Otolaryngology, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, Victoria 3002, Australia.

© 2000 Lippincott Williams & Wilkins, Inc.