Cochlear Implant Translocation: Diagnosis, Prevention, and Clinical Implications

AbstractPurpose of ReviewTo summarize the literature on scalar translocation of cochlear implant (CI) electrode arrays (EAs), including diagnosis, prevention, and clinical implications of such.Recent FindingsRates of translocation vary by EA design, with lateral wall (straight) EAs having rates ranging from 5 to 22% and pre-curved (perimodiolar) having rates of approximately 7% (external stylet) and 30 –50% (internal stylet). All three FDA-cleared CI manufacturers are working on preoperative planning software with the intent of optimizing final EA location and preventing translocation.SummaryTranslocations typically lead to poorer audiologic outcomes. The gold standard for diagnosis involves computed tomography (CT) imaging with portable CT scanners providing immediate postoperative information to detect and potentially correct translocations intraoperatively. Insertion monitoring methods, such as impedance measurements and electrocochleography (ECochG), may alert surgeons of a potential translocation. Robotic insertions with preoperative trajectory plan and insertion monitoring (e.g., ECochG and/or force feedback) may dramatically reduce the incidence of translocations in the not-too-distant future.
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research