Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population Selection
2.2. Patient Clinical Pathway
2.3. Data Collection and Statistical Analysis
3. Results
4. Discussion
4.1. In Vivo Insertion Speed Measurement
Author, Year | Temporal Bone Models | Type of Insertion | Calculated IS (mm/s) | Time of Insertion (s) | Recommended IS (mm/s) | Conclusion |
---|---|---|---|---|---|---|
Rau 2010 [10] | acrylic glass | M | - | 20 | 0.5 | The insertion forces appear to increase if a CI is inserted slower than 0.5 mm/s. |
Kontorinis 2011 [8] | polytetrafluoroethylene (Teflon) | H | mean 1.60 range 0.7–2.75 | - | “slow and stable” | High insertion speeds cause significant increase in the forces. |
Rajan 2012 [4] | in vivo retrospective analysis | H | - | - | 0.25 | A slow electrode insertion speed reduces the occurrence of insertion resistance and increases hearing outcomes. |
Pile 2013 [22] | cadaver | M | 0.5–3 | - | 1 | Mean insertion forces do not significantly reduce after insertion speeds exceed 1 mm/s. |
Todt 2014 [6] | synthetic | M | - | - | 0.25 | Direct correlation between insertion speed and fluid pressure. |
Kesler 2017 [19] | cube of bone surrogate material | H | 0.86 ± 0.32 | - | - | CI electrode insertion at 25 mm/s is not feasible for human operators. |
Hugl 2018 [11] | f-polytetrafluoroethylene (PTFE) | M | 2.8–0.045 | - | “as slow as possible” | A slow electrode insertion speed reduces the occurrence of insertion resistance. |
Snels 2018 [20] | human and synthetic | H, M | - | - | - | Slow insertion increases hearing preservation. |
Aebischer 2021 [3] | epoxy resin | M | 0.33 | 78 | - | Slower and non-constant rate insertions decrease forces. |
4.2. Impact on Surgeon’s Performance
4.3. Insertion Speed in Relation to CI Outcomes
4.4. Limitations and Future Developments
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients | Adult Population | Pediatric Population | |
---|---|---|---|
CI n (%) | 65 (100) | 20 (31) | 45 (69) |
Right side, n (%) | 33 (51) | 10 (50) | 23 (51) |
Age, y (SD) | 18.2 (23.1) | 49.4 (14.0) | 4.4 (4.0) |
≤24 m of age, n (%) | 22 (34) | n.a. | 22 (49) |
All Patients (n = 64) * | Pediatric Population (n = 45) | Adult Population (n = 19) * | p-Value | |
---|---|---|---|---|
Mean (SD) | 0.64 (0.24) * | 0.66 (0.25) | 0.58 (0.21) * | 0.21 |
Minimum value | 0.23 | 0.34 | 0.23 | |
Maximum value | 1.24 * | 1.24 | 1.00 * |
All Patients | Adult Population | Pediatric Population | |
---|---|---|---|
PTA at activation | |||
n | 41 | 27 | 14 |
dB (SD) | 57 (17) | 64 (14) | 43 (12) |
PTA at last evaluation | |||
n | 44 | 30 | 14 |
dB (SD) | 37 (14) | 41 (15) | 29 (8) |
WRS at last evaluation | |||
n | 20 | 7 | 13 |
% (IQR) | 82 (80–100) | 80 (75–95) | 82 (80–100) |
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Concheri, S.; Brotto, D.; Ariano, M.; Daloiso, A.; Di Pasquale Fiasca, V.M.; Sorrentino, F.; Coppadoro, B.; Trevisi, P.; Zanoletti, E.; Franchella, S. Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav. Audiol. Res. 2024, 14, 227-238. https://doi.org/10.3390/audiolres14020021
Concheri S, Brotto D, Ariano M, Daloiso A, Di Pasquale Fiasca VM, Sorrentino F, Coppadoro B, Trevisi P, Zanoletti E, Franchella S. Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav. Audiology Research. 2024; 14(2):227-238. https://doi.org/10.3390/audiolres14020021
Chicago/Turabian StyleConcheri, Stefano, Davide Brotto, Marzia Ariano, Antonio Daloiso, Valerio Maria Di Pasquale Fiasca, Flavia Sorrentino, Beatrice Coppadoro, Patrizia Trevisi, Elisabetta Zanoletti, and Sebastiano Franchella. 2024. "Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav" Audiology Research 14, no. 2: 227-238. https://doi.org/10.3390/audiolres14020021