Variations in microanatomy of the human modiolus require individualized cochlear implantation
Abstract Cochlear variability is of key importance for the clinical use of cochlear implants, the most successful neuroprosthetic device that is surgically placed into the cochlear scala tympani. Despite extensive literature on human cochlear variability, few information is available on the variabil...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-08731-x |
| _version_ | 1811335422316380160 |
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| author | Markus Pietsch Daniel Schurzig Rolf Salcher Athanasia Warnecke Peter Erfurt Thomas Lenarz Andrej Kral |
| author_facet | Markus Pietsch Daniel Schurzig Rolf Salcher Athanasia Warnecke Peter Erfurt Thomas Lenarz Andrej Kral |
| author_sort | Markus Pietsch |
| collection | DOAJ |
| description | Abstract Cochlear variability is of key importance for the clinical use of cochlear implants, the most successful neuroprosthetic device that is surgically placed into the cochlear scala tympani. Despite extensive literature on human cochlear variability, few information is available on the variability of the modiolar wall. In the present study, we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies (CTs) and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Lateral wall measures correlated with modiolar wall measures significantly. ~ 49% of the variability had a common cause. Based on these data we developed a model of the modiolar wall variations and related the model to the design of cochlear implants aimed for perimodiolar locations. The data demonstrate that both the insertion limits relevant for lateral wall damage (approximate range of 4–9 mm) as well as the dimensions required for optimal perimodiolar placement of the electrode (the point of release from the straightener; approximate range of 2–5mm) are highly interindividually variable. The data demonstrate that tip fold-overs of preformed implants likely result from the morphology of the modiolus (with radius changing from base to apex), and that optimal cochlear implantation of perimodiolar arrays cannot be guaranteed without an individualized surgical technique. |
| first_indexed | 2024-04-13T17:24:00Z |
| format | Article |
| id | doaj.art-3a1eaa3a7f02421d875bb5e75fec1125 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T17:24:00Z |
| publishDate | 2022-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-3a1eaa3a7f02421d875bb5e75fec11252022-12-22T02:37:51ZengNature PortfolioScientific Reports2045-23222022-03-0112111610.1038/s41598-022-08731-xVariations in microanatomy of the human modiolus require individualized cochlear implantationMarkus Pietsch0Daniel Schurzig1Rolf Salcher2Athanasia Warnecke3Peter Erfurt4Thomas Lenarz5Andrej Kral6Department of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolDepartment of Otolaryngology, Hannover Medical SchoolAbstract Cochlear variability is of key importance for the clinical use of cochlear implants, the most successful neuroprosthetic device that is surgically placed into the cochlear scala tympani. Despite extensive literature on human cochlear variability, few information is available on the variability of the modiolar wall. In the present study, we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies (CTs) and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Lateral wall measures correlated with modiolar wall measures significantly. ~ 49% of the variability had a common cause. Based on these data we developed a model of the modiolar wall variations and related the model to the design of cochlear implants aimed for perimodiolar locations. The data demonstrate that both the insertion limits relevant for lateral wall damage (approximate range of 4–9 mm) as well as the dimensions required for optimal perimodiolar placement of the electrode (the point of release from the straightener; approximate range of 2–5mm) are highly interindividually variable. The data demonstrate that tip fold-overs of preformed implants likely result from the morphology of the modiolus (with radius changing from base to apex), and that optimal cochlear implantation of perimodiolar arrays cannot be guaranteed without an individualized surgical technique.https://doi.org/10.1038/s41598-022-08731-x |
| spellingShingle | Markus Pietsch Daniel Schurzig Rolf Salcher Athanasia Warnecke Peter Erfurt Thomas Lenarz Andrej Kral Variations in microanatomy of the human modiolus require individualized cochlear implantation Scientific Reports |
| title | Variations in microanatomy of the human modiolus require individualized cochlear implantation |
| title_full | Variations in microanatomy of the human modiolus require individualized cochlear implantation |
| title_fullStr | Variations in microanatomy of the human modiolus require individualized cochlear implantation |
| title_full_unstemmed | Variations in microanatomy of the human modiolus require individualized cochlear implantation |
| title_short | Variations in microanatomy of the human modiolus require individualized cochlear implantation |
| title_sort | variations in microanatomy of the human modiolus require individualized cochlear implantation |
| url | https://doi.org/10.1038/s41598-022-08731-x |
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