Intracochlear New Fibro-Ossification and Neuronal Degeneration Following Cochlear Implant Electrode Translocation: Long-Term Histopathological Findings in Humans.
Otol Neurotol
; 43(2): e153-e164, 2022 02 01.
Article
em En
| MEDLINE
| ID: mdl-35015749
ABSTRACT
OBJECTIVE:
We aim to assess the histopathology of human temporal bones (TBs) with evidence of cochlear implantation (CI) electrode scalar translocation. STUDYDESIGN:
Otopathology study.SETTING:
Otopathology laboratory. PATIENTS TBs from patients who had a history of CI and histopathological evidence of interscalar translocation. Specimens with electrode placed entirely within the ST served as controls. INTERVENTION Histopathological assessment of human TBs. MAIN OUTCOMEMEASURES:
TBs from each patient were harvested postmortem and histologically analyzed for intracochlear changes in the context of CI electrode translocation and compared to controls. Intracochlear new fibro-ossification, and spiral ganglion neuron (SGN) counts were assessed. Postoperative word recognition scores (WRS) were also compared.RESULTS:
Nineteen human TBs with electrode translocation and eight controls were identified. The most common site of translocation was the ascending limb of the basal turn (nâ=â14 TBs). The average angle of insertion at the point of translocation was 159°â±â79°. Eighteen translocated cases presented moderate fibroosseous changes in the basal region of the cochlea, extending to the translocation point and/or throughout the electrode track in 42%. Lower SGN counts were more pronounced in translocated cases compared to controls, with a significant difference for segment II (pâ=â0.019). Although final postoperative hearing outcomes were similar between groups, translocated cases had slower rate of improvement in WRS (pâ=â0.021).CONCLUSIONS:
Cochlear implant electrode translocation was associated with greater fibroosseous formation and lower SGN population. Our findings suggest that scalar translocations may slow the rate of improvement in WRS overtime as compared to atraumatic electrode insertions.Level of evidence IV.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Implantes Cocleares
/
Implante Coclear
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article