Journal Mobile Options
Table of Contents
Vol. 16, No. 5, 2011
Issue release date: July 2011
Audiol Neurotol 2011;16:336–346

The Histopathology of Revision Cochlear Implantation

Lee J. · Eddington D.K. · Nadol J.B.
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

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


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).

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Buchman CA, Higgins CA, Cullen R, Pillsbury HC: Revision cochlear implant surgery in adult patients with suspected device malfunction. Otol Neurotol 2004;25:504–510.
  2. Coté M, Ferron P, Bergeron F, Bussières R: Cochlear reimplantation: causes of failure, outcomes, and audiologic performance. Laryngoscope 2007;117:1225–1235.
  3. Cullen RD, Fayad JN, Luxford WM, Buchman CA: Revision cochlear implant surgery in children. Otol Neurotol 2008;29:214–220.
  4. Fayad JN, Baino T, Parisier SC: Revision cochlear implant surgery: causes and outcome. Otolaryngol Head Neck Surg 2004;131:429–432.
  5. Fayad JN, Eisenberg LS, Gillinger M, Winter M, Martinez AS, Luxford WM: Clinical performance of children following revision surgery for a cochlear implant. Otolaryngol Head Neck Surg 2006;134:379–384.
  6. Gosepath J, Lippert K. Keilmann A, Mann WJ: Analysis of fifty-six cochlear implant device failures. ORL J Otorhinolaryngol Relat Spec 2009;71:142–147.
  7. Greenberg AB, Myers MW, Hartshorn DO, Miller JM, Altschuler RA: Cochlear electrode reimplantation in the guinea pig. Hear Res 1992;61:19–23.
  8. Guild SR: A graphic reconstruction method for the study of the organ of Corti. Anat Rec 1921;22:141–157.

    External Resources

  9. Henson AM, Slattery WH III, Luxford WM, Mills DM: Cochlear implant performance after reimplantation. A multicenter study. Am J Otol 1999;20:56–64.
  10. Jackler RK, Leake PA, McKerrow WS: Cochlear implant revision: effects of reimplantation on the cochlea. Ann Otol Rhinol Laryngol 1989;98:813–820.
  11. Kang SY, Zwolan TA, Kileny PR, Niparko JK, Driscoll CL, Shelton C, Telian SA: Incomplete electrode extraction during cochlear implant revision. Otol Neurotol 2009;30:160–164.
  12. Lassig AA, Zwolan TA, Telian SA: Cochlear implant failures and revision. Otol Neurotol 2005;26:624–634.
  13. Li PMMC, Somdas MA, Eddington DK, Nadol JB Jr: Analysis of intracochlear new bone and fibrous tissue formation in human subjects with cochlear implants. Ann Otol Rhinol Laryngol 2007;116:731–738.
  14. Linthicum FH Jr, Fayad J, Otto SR, Galey FR, House WF: Cochlear implant histopathology. Am J Otol 1991;12:245–311.

    External Resources

  15. Miyamoto RT, Svirsky MA, Myres WA, Kirk KI, Schulte J: Cochlear implant reimplantation. Am J Otol 1997;18:S60–S61.
  16. Nadol JB Jr: Quantification of human spiral ganglion cells by serial section reconstruction and segmental density estimates. Am J Otolaryngol 1988;9:47–51.
  17. Nadol JB Jr, Ketten DR, Burgess BJ: Otopathology in a case of multichannel cochlear implantation. Laryngoscope 1994;104:299–303.
  18. Rabinowitz WM, Eddington DK, Delhorne LA, Cuneo PA: Relations among different measures of speech reception in subjects using a cochlear implant. J Acoust Soc Am 1992;92:1869–1881.
  19. Rivas A, Marlowe AL, Chinnici JE, Niparko JK, Francis HW: Revision cochlear implantation surgery in adults: indications and results. Otol Neurotol 2008;29:639–648.
  20. Rubinstein JT, Parkinson WS, Lowder MW, Gantz BJ, Nadol JB Jr, Tyler, RS: Single-channel to multichannel conversions in adult cochlear implant subjects. Am J Otol 1998;19:461–466.
  21. Schuknecht HF: Pathology of the Ear, ed 2. Philadelphia, Lea & Febiger 1993, pp 1–29.
  22. Shepherd RK, Clark GM, Xu SA, Pyman BC: Cochlear pathology following reimplantation of a multichannel scala tympani electrode array in the macaque. Am J Otol 1995;16:186–199.
  23. Somdas MA, Li PMMC, Whiten DM, Eddington DK, Nadol JB Jr: Quantitative evaluation of new bone and fibrous tissue in the cochlea following cochlear implantation in the human. Audiol Neurotol 2007;12:277–284.
  24. Sorrentino T, Coté M, Eter E, Laborde M, Cochard N, Deguine O, Fraysse B: Cochlear reimplantations: technical and surgical failures. Acta Otolaryngol 2009;129:380–384.
  25. Zeitler DM, Budenz CL, Roland JT Jr: Revision cochlear implantation. Curr Opin Otolaryngol Head Neck Surg 2009;17:334–338.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50