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Erschienen in: Surgical and Radiologic Anatomy 7/2015

01.09.2015 | Original Article

Micro-CT scan, electron microscopy and optical microscopy study of insertional traumas of cochlear implants

verfasst von: Alexia Le Breton, Franck Jegoux, Paul Pilet, Benoit Godey

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2015

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Abstract

Purpose

Knowledge of cochlear trauma resulting from the implantation of electrodes is important for the development of atraumatic surgical techniques. The purpose of this study was to demonstrate the advantages of micro-CT scanning, back-scattered electron microscopy (BSEM) and optical microscopy (OM) in understanding the mechanisms of cochlear trauma due to cochlear implantation.

Method

Our study involved six petrous bones removed from fresh human cadavers: one control specimen plus five other specimens that were surgically implanted with Neurelec Digisonic SP EVO® electrode arrays. All six specimens underwent glycol methyl methacrylate embedding, were examined via micro-CT scan and were then sectioned for histological analysis of undecalcified samples via BSEM and OM.

Results

The 2D micro-CT scan reconstructions did not display cochlear microtrauma due to a limited resolution and the loss of information caused by the metallic artifacts of the intracochlear electrodes. The 3D reconstructions displayed the quality of the electrode array positioning in the cochlea and enabled determining the axes on which to section the specimens for histological examination. BSEM afforded a clear view of the damage to the osseous structures of the cochlea, but did not display the soft tissue injuries. OM enabled viewing and grading the histological lesions resulting from insertion.

Conclusion

In our opinion, the combination of 3D micro-CT scan reconstructions and histological analysis using OM appears to be the best method to analyze this type of trauma.
Literatur
1.
Zurück zum Zitat Adunka O, Kiefer J, Unkelbach MH, Lehnert T, Gstoettner W (2004) Development and evaluation of an improved cochlear implant electrode design for electric acoustic stimulation. Laryngoscope 114(7):1237–1241CrossRefPubMed Adunka O, Kiefer J, Unkelbach MH, Lehnert T, Gstoettner W (2004) Development and evaluation of an improved cochlear implant electrode design for electric acoustic stimulation. Laryngoscope 114(7):1237–1241CrossRefPubMed
2.
Zurück zum Zitat Adunka OF, Pillsbury HC, Adunka MC, Buchman CA (2010) Is electric acoustic stimulation better than conventional cochlear implantation for speech perception in quiet? Otol Neurotol 31(7):1049–1054CrossRefPubMed Adunka OF, Pillsbury HC, Adunka MC, Buchman CA (2010) Is electric acoustic stimulation better than conventional cochlear implantation for speech perception in quiet? Otol Neurotol 31(7):1049–1054CrossRefPubMed
3.
Zurück zum Zitat Bird PA, Murray DP, Zhang M, Begg EJ (2011) Intratympanic versus intravenous delivery of dexamethasone and dexamethasone sodium phosphate to cochlear perilymph. Otol Neurotol 32(6):933–936CrossRefPubMed Bird PA, Murray DP, Zhang M, Begg EJ (2011) Intratympanic versus intravenous delivery of dexamethasone and dexamethasone sodium phosphate to cochlear perilymph. Otol Neurotol 32(6):933–936CrossRefPubMed
4.
Zurück zum Zitat Diogo I, Franke N, Steinbach-Hundt S, Mandapathil M, Weiss R, Werner JA, Güldner C (2014) Differences of radiological artefacts in cochlear implantation in temporal bone and complete head. Cochlear Implants Int 15(2):112–117CrossRefPubMed Diogo I, Franke N, Steinbach-Hundt S, Mandapathil M, Weiss R, Werner JA, Güldner C (2014) Differences of radiological artefacts in cochlear implantation in temporal bone and complete head. Cochlear Implants Int 15(2):112–117CrossRefPubMed
5.
Zurück zum Zitat Eshraghi AA, Gupta C, Van De Water TR, Bohorquez JE, Garnham C, Bas E, Talamo VM (2013) Molecular mechanisms involved in cochlear implantation trauma and the protection of hearing and auditory sensory cells by inhibition of c-Jun-N-terminal kinase signaling. Laryngoscope 123(Suppl):S1–S14CrossRefPubMed Eshraghi AA, Gupta C, Van De Water TR, Bohorquez JE, Garnham C, Bas E, Talamo VM (2013) Molecular mechanisms involved in cochlear implantation trauma and the protection of hearing and auditory sensory cells by inhibition of c-Jun-N-terminal kinase signaling. Laryngoscope 123(Suppl):S1–S14CrossRefPubMed
6.
Zurück zum Zitat Eshraghi AA, Yang NW, Balkany TJ (2003) Comparative study of cochlear damage with three perimodiolar electrode designs. Laryngoscope 113(3):415–419CrossRefPubMed Eshraghi AA, Yang NW, Balkany TJ (2003) Comparative study of cochlear damage with three perimodiolar electrode designs. Laryngoscope 113(3):415–419CrossRefPubMed
7.
Zurück zum Zitat Gantz BJ, Turner C, Gfeller KE, Lowder MW (2005) Preservation of hearing in cochlear implant surgery: advantages of combined electrical and acoustical speech processing. Laryngoscope 115(5):796–802CrossRefPubMed Gantz BJ, Turner C, Gfeller KE, Lowder MW (2005) Preservation of hearing in cochlear implant surgery: advantages of combined electrical and acoustical speech processing. Laryngoscope 115(5):796–802CrossRefPubMed
8.
Zurück zum Zitat Güldner C, Wiegand S, Weiss R, Bien S, Sesterhenn A, Teymoortash A, Diogo I (2012) Artifacts of the electrode in cochlea implantation and limits in analysis of deep insertion in cone beam tomography (CBT). Eur Arch Otorhinolaryngol 269(3):767–772CrossRefPubMed Güldner C, Wiegand S, Weiss R, Bien S, Sesterhenn A, Teymoortash A, Diogo I (2012) Artifacts of the electrode in cochlea implantation and limits in analysis of deep insertion in cone beam tomography (CBT). Eur Arch Otorhinolaryngol 269(3):767–772CrossRefPubMed
9.
Zurück zum Zitat Hodez C, Griffaton-Taillandier C, Bensimon J-L (2011) Cone Beam imaging: application in ENT. Eur Ann Otorhinolaryngol Head Neck Dis 128(2):77–91CrossRef Hodez C, Griffaton-Taillandier C, Bensimon J-L (2011) Cone Beam imaging: application in ENT. Eur Ann Otorhinolaryngol Head Neck Dis 128(2):77–91CrossRef
10.
Zurück zum Zitat Kiefer J, Müller J, Pfennigdorff T et al (1996) Speech understanding in quiet and in noise with the CIS speech coding strategy (MED-EL Combi-40) compared to the multipeak and spectral peak strategies (nucleus). ORL J Otorhinolaryngol Relat Spec 58(3):127–135CrossRefPubMed Kiefer J, Müller J, Pfennigdorff T et al (1996) Speech understanding in quiet and in noise with the CIS speech coding strategy (MED-EL Combi-40) compared to the multipeak and spectral peak strategies (nucleus). ORL J Otorhinolaryngol Relat Spec 58(3):127–135CrossRefPubMed
11.
Zurück zum Zitat Lecerf P, Bakhos D, Cottier J-P, Lescanne E, Trijolet JP, Robier A (2011) Midmodiolar reconstruction as a valuable tool to determine the exact position of the cochlear implant electrode array. Otol Neurotol 32(7):1075–1081CrossRefPubMed Lecerf P, Bakhos D, Cottier J-P, Lescanne E, Trijolet JP, Robier A (2011) Midmodiolar reconstruction as a valuable tool to determine the exact position of the cochlear implant electrode array. Otol Neurotol 32(7):1075–1081CrossRefPubMed
12.
Zurück zum Zitat Li PM, Wang H, Northrop C, Merchant SN, Nadol JB Jr (2007) Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol 28(5):641–648PubMedCentralCrossRefPubMed Li PM, Wang H, Northrop C, Merchant SN, Nadol JB Jr (2007) Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol 28(5):641–648PubMedCentralCrossRefPubMed
13.
Zurück zum Zitat Nadol JB Jr, Shiao JY, Burgess BJ et al (2001) Histopathology of cochlear implants in humans. Ann Otol Rhinol Laryngol 110(9):883–891CrossRefPubMed Nadol JB Jr, Shiao JY, Burgess BJ et al (2001) Histopathology of cochlear implants in humans. Ann Otol Rhinol Laryngol 110(9):883–891CrossRefPubMed
14.
Zurück zum Zitat Nguyen Y, Miroir M, Kazmitcheff G et al (2012) Cochlear implant insertion forces in microdissected human cochlea to evaluate a prototype array. Audiol Neurootol 17(5):290–298CrossRefPubMed Nguyen Y, Miroir M, Kazmitcheff G et al (2012) Cochlear implant insertion forces in microdissected human cochlea to evaluate a prototype array. Audiol Neurootol 17(5):290–298CrossRefPubMed
15.
Zurück zum Zitat Parkin JL, Eddington DK, Orth JL, Brackmann DE (1985) Speech recognition experience with multichannel cochlear implants. Otolaryngol Head Neck Surg 93(5):639–645PubMed Parkin JL, Eddington DK, Orth JL, Brackmann DE (1985) Speech recognition experience with multichannel cochlear implants. Otolaryngol Head Neck Surg 93(5):639–645PubMed
16.
Zurück zum Zitat Plenk H Jr (1986) The microscopic evaluation of hard tissue implants. In: William DF (ed) Techniques of biocompatibility testing, vol 1. CRC-Press, Boca Raton, pp 63–81 Plenk H Jr (1986) The microscopic evaluation of hard tissue implants. In: William DF (ed) Techniques of biocompatibility testing, vol 1. CRC-Press, Boca Raton, pp 63–81
17.
Zurück zum Zitat Roland JT Jr, Zeitler DM, Jethanamest D, Huang TC (2008) Evaluation of the short hybrid electrode in human temporal bones. Otol Neurotol 29(4):482–488CrossRefPubMed Roland JT Jr, Zeitler DM, Jethanamest D, Huang TC (2008) Evaluation of the short hybrid electrode in human temporal bones. Otol Neurotol 29(4):482–488CrossRefPubMed
18.
Zurück zum Zitat Trieger A, Schulze A, Schneider M, Zahnert T, Mürbe D (2011) In vivo measurements of the insertion depth of cochlear implant arrays using flat-panel volume computed tomography. Otol Neurotol 32(1):152–157CrossRefPubMed Trieger A, Schulze A, Schneider M, Zahnert T, Mürbe D (2011) In vivo measurements of the insertion depth of cochlear implant arrays using flat-panel volume computed tomography. Otol Neurotol 32(1):152–157CrossRefPubMed
19.
20.
Zurück zum Zitat Vivero RJ, Joseph DE, Angeli S, He J, Chen S, Eshraghi AA, Balkany TJ, Van de Walter TR (2008) Dexamethasone base conserves hearing from electrode trauma-induced hearing loss. Laryngoscope 118(11):2028–2035CrossRefPubMed Vivero RJ, Joseph DE, Angeli S, He J, Chen S, Eshraghi AA, Balkany TJ, Van de Walter TR (2008) Dexamethasone base conserves hearing from electrode trauma-induced hearing loss. Laryngoscope 118(11):2028–2035CrossRefPubMed
21.
Zurück zum Zitat Von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Stürzebecher E, Klinke R (1999) Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. ORL J Otorhinolaryngol Relat Spec 61(6):334–340CrossRef Von Ilberg C, Kiefer J, Tillein J, Pfenningdorff T, Hartmann R, Stürzebecher E, Klinke R (1999) Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. ORL J Otorhinolaryngol Relat Spec 61(6):334–340CrossRef
22.
Zurück zum Zitat Wardrop P, Whinney D, Rebscher SJ, Luxford W, Leake P (2005) A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. II: comparison of Spiral Clarion and HiFocus II electrodes. Hear Res 203(1–2):68–79CrossRefPubMed Wardrop P, Whinney D, Rebscher SJ, Luxford W, Leake P (2005) A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. II: comparison of Spiral Clarion and HiFocus II electrodes. Hear Res 203(1–2):68–79CrossRefPubMed
23.
Zurück zum Zitat Wardrop P, Whinney D, Rebscher SJ, Roland JT Jr, Luxford W, Leake PA (2005) A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. I: comparison of nucleus banded and nucleus contour electrodes. Hear Res 203(1–2):54–67CrossRefPubMed Wardrop P, Whinney D, Rebscher SJ, Roland JT Jr, Luxford W, Leake PA (2005) A temporal bone study of insertion trauma and intracochlear position of cochlear implant electrodes. I: comparison of nucleus banded and nucleus contour electrodes. Hear Res 203(1–2):54–67CrossRefPubMed
24.
Zurück zum Zitat Welling DB, Hinojosa R, Gantz BJ, Lee JT (1993) Insertional trauma of multichannel cochlear implants. Laryngoscope 103(9):995–1001CrossRefPubMed Welling DB, Hinojosa R, Gantz BJ, Lee JT (1993) Insertional trauma of multichannel cochlear implants. Laryngoscope 103(9):995–1001CrossRefPubMed
25.
Zurück zum Zitat Wright CG, Roland PS, Kuzma J (2005) Advanced bionics thin lateral and Helix II electrodes: a temporal bone study. Laryngoscope 115(11):2041–2045CrossRefPubMed Wright CG, Roland PS, Kuzma J (2005) Advanced bionics thin lateral and Helix II electrodes: a temporal bone study. Laryngoscope 115(11):2041–2045CrossRefPubMed
Metadaten
Titel
Micro-CT scan, electron microscopy and optical microscopy study of insertional traumas of cochlear implants
verfasst von
Alexia Le Breton
Franck Jegoux
Paul Pilet
Benoit Godey
Publikationsdatum
01.09.2015
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 7/2015
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-015-1469-9

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