Tip Fold-over in Cochlear Implantation: Case Series.
Otol Neurotol
; 38(2): 199-206, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-27918363
ABSTRACT
OBJECTIVE:
To describe the incidence, clinical presentation, and performance of cochlear implant (CI) recipients with tip fold-over. STUDYDESIGN:
Retrospective case series.SETTING:
Tertiary referral center. PATIENTS CI recipients who underwent postoperative computed tomography (CT) scanning. INTERVENTION(S) Tip fold-over was identified tomographically using previously validated software that identifies the electrode array. Electrophysiologic testing including spread of excitation or electric field imaging (EFI) was measured on those with fold-over. MAIN OUTCOME MEASURE(S) Location of the fold-over; audiological performance pre and postselective deactivation of fold-over electrodes.RESULTS:
Three hundred three ears of 235 CI recipients had postoperative CTs available for review. Six (1.98%) had tip fold-over with 5/6 right-sided ears. Tip fold-over occurred predominantly at 270 degrees and was associated with precurved electrodes (5/6). Patients did not report audiological complaints during initial activation. In one patient, the electrode array remained within the scala tympani with preserved residual hearing despite the fold-over. Spread of excitation supported tip fold-over, but the predictive value was not clear. EFI predicted location of the fold-over with clear predictive value in one patient. At an average follow-up of 11 months, three subjects underwent deactivation of the overlapping electrodes with two of them showing marked audiological improvement.CONCLUSION:
In a large academic center with experienced surgeons, tip fold-over occurred at a rate of 1.98% but was not immediately identifiable clinically. CT imaging definitively showed tip fold-over. Deactivating involved electrodes may improve performance possibly avoiding revision surgery. EFI may be highly predictive of tip fold-over and can be run intraoperatively, potentially obviating the need for intraop fluoroscopy.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Implantes Cocleares
/
Cóclea
/
Implante Coclear
/
Perda Auditiva
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
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Child
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Otol Neurotol
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article