Ear and Hearing · 2002 · 41 citations · 1 references
Health ProfessionsOtolaryngologySurgeryCochlear ImplantsHearing ScienceImplant SurgeryCochlear AnatomyCochlear Implant AnatomyCochlear ImplantationElectrode Array DesignElectrode PlacementSurgical ImplantationCochlear Implant Electrode ArraysCochleostomy ApproachCochleostomy InsertionElectrode Array InsertionPerimodiolar Electrode ArraysPerimodiolar Electrode PlacementPerimodiolar Electrode PositioningPerimodiolar Electrodes
The Nucleus C124R (Contour) cochlear implant features a perimodiolar electrode and a distinct surgical approach compared to earlier models, and other variations of the technique exist. The authors aim to explain the rationale for perimodiolar electrodes and present laboratory evidence validating the design and safety of the C124R array. The surgical technique for the C124R involves a smaller incision and electronics recess, a larger cochleostomy, a subpericranial posterior pocket without fixation, and a distinct insertion process tailored to the electrode’s size and shape, as practiced by an experienced implant center. Surgeons report the C124R is easier to place than earlier generations, with uncommon complications to date.
This paper deals with the Nucleus C124R (CS) (Contour) cochlear Implant: its characteristics, differences compared with the previous generation of devices, the perimodiolar electrode, and the surgical technique used for safe insertion. We also discuss the rationale behind perimodiolar electrodes in general, as well as the results of laboratory studies validating the design and safety of this particular electrode array. The differences in surgical technique between this device and prior Nucleus cochlear implants are as follows: the incision and the size of the well, or recess, for the electronics are smaller; the cochleostomy is larger; the posterior portion is placed in a subpericranial pocket, not tied down, before electrode insertion; and the insertion process itself is quite different, due to the nature of the electrode, its size, shape, and stylet. The technique described is that used by one experienced cochlear implant center, and reflect the authors' practice. Clearly, there are other possible variations on this theme, which may be equally satisfactory in other hands. Most surgeons find this device to be easier to place than previous generations: complications to date have been uncommon.
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