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The Histopathology of Revision Cochlear Implantation

Lee J.a, b, e · Eddington D.K.a–d · Nadol J.B.a, b, d
aDepartment of Otology and Laryngology, Harvard Medical School, bDepartment of Otolaryngology, Massachusetts Eye and Ear Infirmary, cCochlear Implant Research Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Mass., and dSpeech and Hearing Bioscience and Technology Program, Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Mass., USA; eDepartment of Otolaryngology-Head and Neck Surgery, Chosun University, College of Medicine, Gwang Ju, South Korea Audiol Neurotol 2011;16:336–346 (DOI:10.1159/000322307)

Abstract

The current study evaluates histopathologic changes in the temporal bones of 4 human subjects who underwent revision cochlear implantation. Specimens were removed at autopsy, fixed and prepared for histological study by standard techniques. Specimens were serially sectioned, reconstructed by two-dimensional methods, and the tracks of the initial and revision cochlear-implant electrodes identified. The tracks were of three types: a ‘common track’ (shared by the reimplantation electrode and initial electrode), ‘two tracks’ (where the reimplantation electrode was in a different track than that of the initial electrode) and ‘one track’ (where the reimplantation electrode extended beyond the initial electrode, forming a single track). Associated histopathologic findings (new bone formation, fibrosis or inflammatory cells, and cochlear fluid) were evaluated for the three types of tracks. In all 4 subjects, the insertion depth of the revision cochlear implant was deeper than that of the initial cochlear implant. The primary track of the initial implantation did not interfere with insertion of a revision cochlear implant, and the trajectory of the revision electrode did not always follow the primary track. In cochlear segments with a common track or two tracks, the mean (across-subject) percent area of the extraelectrode cochlear duct filled with abnormal (new bone or fibrotic) tissue (43.2%) was significantly greater than the mean percent area occupied by fluid (13.4%; t = 3.12, d.f. = 19.9, p = 0.003).

 

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