Untersuchung der cochleären Mikromorphologie und des Querschnitts der cochleären Gänge unter Berücksichtigung der Entstehung von Insertionsschäden bei der Cochlea-Elektroden-Insertion

INTRODUCTION: Cochlear implantation is a widely accepted treatment for deafness and high grade sensorineural hearing loss. Though the device and the implantation methods are continuously optimized, no atraumatic implantation can be achieved. Reduction of insertional trauma is important for the preservation of residual hearing and on the background of the enhanced indication for cochlear implantation. This study was performed to examine the intracochlear spaces and to correlate the micro-morphology of the cochlear ducts with frequent patterns of intracochlear insertional trauma. METHODS: Histologic temporal bone series from the “Wittmaack temporal bone collection” (Hamburg, Germany) were examined. The specimens were digitized and the internal dimensions of the cochlear scalae were measured with computer software that was developed for this study. These data were evaluated in reference to the cochlear spiral that was reconstructed for every cochlea according to the “graphical cochlea reconstruction”-method. RESULTS: The Scala tympani decreases in height during the first half cochlear turn, reaches then a constant value until the middle of the third turn, increases slightly again and then decreases toward the apex. In the first cochlear turn, previous to the ascending part, the height drops by 300µm. In this region the intersegmental decrease of height significantly varies downward from a supposed linear intersegmental decrease (p <= 0,001). The curve indicating the combined height of the Scala vestibuli and the Scala media shows an inverted shape. DISCUSSION: The localisation of the distinct decrease in height of the Scala tympani correlates with the localisation of frequent cochlear-electrode insertional trauma. From the literature it is known that the intracochlear trauma in this area very often is severe and that optimization of electrode shape and insertion methods may have no impact on it. The curved shape of the cochlear duct as well as the specific intracochlear micro-morphology and the interindividual differences show a complex multifactorial interrelationship that has impact on intracochlear insertional trauma and which may not be compensated until the development of actively navigated cochlear electrodes.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Biedron, Slavomir

Contributors dc:contributor

• Westhofen, Martin

• info:eu-repo/classification/ddc/610
• Cochlea
• Cochlear-Implantat
• Medizin
• Scala tympani
• graphische Rekonstruktion
• Insertionstrauma
• graphical reconstruction
• insertional trauma

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113025%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50482