Objective: To investigate the insertion speed and its impact on electrode insertion characteristics, hearing preservation and clinical vestibular function in a prospective cohort study with a retrospective control group at a tertiary otology/neurotology centre. Interventions: Hearing-preserving cochlear implantation using systemic and topical steroids in conjunction with a round-window approach, a complete cochlear coverage electrode and two different electrode insertion speeds [60 mm/min (n = 18) vs. 15 mm/min (n = 22)] was performed. Results: The insertion speed had a significant impact on various insertion characteristics as well as hearing preservation and vestibular function. In conclusion, a slow electrode insertion speed appears to facilitate full electrode insertion, reduce the occurrence of insertion resistance as well as promote preservation of residual hearing and vestibular function after cochlear implantation.

Keywords:
Vertigo, Vestibular diseases, Cochlear implantation, Hearing loss, Inner ear, Minimal invasive surgery
1.
Adunka O, Unkelbach MH, Mack M, Hambek M, Gstoettner W, Kiefer J: Cochlear implantation via the round window membrane minimizes trauma to cochlear structures: a histologically controlled insertion study. Acta Otolaryngol 2004;124:807–812.
2.
Chandrasekhar SS: Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 2001;22:18–23.
3.
Dorman MF, Gifford RH: Combining acoustic and electric stimulation in the service of speech recognition. Int J Audiol 2010;49:912–919.
4.
Enticott JC, Eastwood HT, Briggs RJ, Dowell RC, O’Leary SJ: Methylprednisolone applied directly to the round window reduces dizziness after cochlear implantation: a randomized clinical trial. Audiol Neurootol 2011;16:289–303.
5.
Enticott JC, Tari S, Koh SM, Dowell RC, O’Leary SJ: Cochlear implant and vestibular function. Otol Neurotol 2006;27:824–830.
6.
Gifford RH, Dorman MF, Brown CA: Psychophysical properties of low-frequency hearing: implications for perceiving speech and music via electric and acoustic stimulation. Adv Otorhinolaryngol 2010;67:51–60.
7.
Gstoettner W, Helbig S, Settevendemie C, Baumann U, Wagenblast J, Arnoldner C: A new electrode for residual hearing preservation in cochlear implantation: first clinical results. Acta Otolaryngol 2009;129:372–379.
8.
Ishii T, Takayama M, Takahashi Y: Mechanical properties of human round window, basilar and Reissner’s membranes. Acta Otolaryngol Suppl 1995;519:78–82.
9.
Kontorinis G, Lenarz T, Stöver T, Paasche G: Impact of the insertion speed of cochlear implant electrodes on the insertion forces. Otol Neurotol 2011;32:565–570.
10.
Krause E, Louza JP, Wechtenbruch J, Gürkov R: Influence of cochlear implantation on peripheral vestibular receptor function. Otolaryngol Head Neck Surg 2010;142:809–813.
11.
Krause E, Louza JP, Wechtenbruch J, Hempel JM, Rader T, Gürkov R: Incidence and quality of vertigo symptoms after cochlear implantation. J Laryngol Otol 2009;123:278–282.
12.
Lim YS, Park SI, Kim YH, Oh SH, Kim SJ: Three-dimensional analysis of electrode behavior in a human cochlear model. Med Eng Phys 2005;27:695–703.
13.
Majdani O, Schurzig D, Hussong A, Rau T, Wittkopf J, Lenarz T, Labadie RF: Force measurement of insertion of cochlear implant electrode arrays in vitro: comparison of surgeon to automated insertion tool. Acta Otolaryngol 2010;130:31–36.
14.
Podskarbi-Fayette R, Pilka A, Skarzynski H: Electric stimulation complements functional residual hearing in partial deafness. Acta Otolaryngol 2010;130:888–896.
15.
Radeloff A, Unkelbach MH, Mack MG, Settevendemie C, Helbig S, Mueller J, Hagen R, Mlynski R: A coated electrode carrier for cochlear implantation reduces insertion forces. Laryngoscope 2009;119:959–963.
16.
Rajan GP, Kuthubutheen J, Hedne N, Krishnaswamy J: The role of preoperative, intratympanic glucocorticoids for hearing preservation in cochlear implantation: a prospective clinical study. Laryngoscope 2012;122:190–195.
17.
Rebscher SJ, Hetherington A, Bonham B, Wardrop P, Whinney D, Leake PA: Considerations for design of future cochlear implant electrode arrays: electrode array stiffness, size, and depth of insertion. J Rehabil Res Dev 2008;45:731–747.
18.
Roland JT, Shevla M, Gibson P, Treaba C: Electrode insertion mechanics and outer wall forces with the nucleus 24 contour advance electrode. Cochlear Implants Int 2005;6(suppl 1):5–8.
19.
Roland PS, Wright CG, Isaacson B: Cochlear implant electrode insertion: the round window revisited. Laryngoscope 2007;117:1397–1402.
20.
Skarzynski H, Lorens A, Piotrowska A, Anderson I: Partial deafness cochlear implantation in children. Int J Pediatr Otorhinolaryngol 2007;71:1407–1413.
21.
Tabuchi K, Oikawa K, Murashita H, Hoshino T, Tsuji S, Hara A: Protective effects of glucocorticoids on ischemia-reperfusion injury of outer hair cells. Laryngoscope 2006;116:627–629.
22.
Todd CA, Naghdy F, Svehla MJ: Force application during cochlear implant insertion: an analysis for improvement of surgeon technique. IEEE Trans Biomed Eng 2007;54:1247–1255.
23.
Usami S, Moteki H, Suzuki N, Fukuoka H, Miyagawa M, Nishio SY, Takumi Y, Iwasaki S, Jolly C: Achievement of hearing preservation in the presence of an electrode covering the residual hearing region. Acta Otolaryngol 2011;131:405–412.
24.
Verbist BM, Ferrarini L, Briaire JJ, Zarowski A, Admiraal-Behloul F, Olofsen H, Reiber JH, Frijns JH: Anatomic considerations of cochlear morphology and its implications for insertion trauma in cochlear implant surgery. Otol Neurotol 2009;30:471–477.
25.
von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Stürzebecher E, Klinke R: Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. ORL J Otorhinolaryngol Relat Spec 1999;61:334–340.
26.
Zhang T, Dorman MF, Spahr AJ: Information from the voice fundamental frequency (F0) region accounts for the majority of the benefit when acoustic stimulation is added to electric stimulation. Ear Hear 2010;31:63–69.
© 2012 S. Karger AG, Basel
2012
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