Special Considerations Regarding Securing the Electrode Array

For all three devices manufactured for the U.S. marketplace, securing of the electrode array at the cochleostomy site and at the facial recess is important. The cochlea and facial recess are the same size at birth as they are throughout adulthood and therefore, it is important to secure the electrode array at the cochleostomy with the fascia graft, which will scar in place and bridge the surrounding promontory to the electrode array. A second site of stabilization at the facial recess, with fascia grafts between the facial nerve and the electrode array as well as between the electrode array and the tympanic annulus, will further stabilize this relationship with the electrode array to the cochlea and facial recess (Fig. 28-9). This is important in children because of the relationship between head growth and the cochlear implant. The distal sites of stabilization at the cochleostomy and facial recess will secure the electrode array anteriorly, whereas the sutures and fibrous capsule that will form around the internal receiver, as well as the electrode within the trough created at the time of surgery, will stabilize this portion of the electrode array at the proximal portion of the cochlear implant. The remainder of the electrode array is coiled within the mastoid, and this air-filled space allows the uncoiling of this electrode array during development as the child's head grows. This mechanism allows

Longer

Basal turn

Longer

Basal turn

Cochlear Ossification
Shorter array
Cochleostomy

FIGURE 28-7 The Med-El C40HGB (split electrode array) is used when there is severe cochlear ossification. If the basal turn is more ossified than the more apical turns of the cochlea, the shorter electrode array containing five pairs of electrode contacts is placed into the basal turn, whereas the longer array containing seven pairs of electrode contacts is placed more distally via a second cochleostomy. The Cochlear Corporation manufactures a similar split electrode array.

FIGURE 28-7 The Med-El C40HGB (split electrode array) is used when there is severe cochlear ossification. If the basal turn is more ossified than the more apical turns of the cochlea, the shorter electrode array containing five pairs of electrode contacts is placed into the basal turn, whereas the longer array containing seven pairs of electrode contacts is placed more distally via a second cochleostomy. The Cochlear Corporation manufactures a similar split electrode array.

FIGURE 28-8 The Med-El C40HGB (split electrode array) can be used when there is severe cochlear ossification. If the basal turn is less ossified than the more apical turns of the cochlea, the longer electrode array containing seven pairs of electrode contacts is placed into the basal turn, whereas the shorter array containing five pairs of electrode contacts is placed more distally via a second cochleostomy. The Cochlear Corporation manufactures a similar split electrode array.

Tympanic Membrane Pathology
FIGURE 28—9 Fascia is placed between the electrode array and the facial nerve as well as between the electrode array and the chorda tympani/annulus. The remaining electrode array is coiled within the mastoid cavity.

the accomplishment of natural growth and development while maintaining the integrity and position of the cochlear implant and its electrode array within the cochlea.

Was this article helpful?

0 0
How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook


Post a comment