• Cochlear implant(s);
  • Hybrid-L24®;
  • electroacoustic stimulation;
  • microcomputed tomography;
  • CT microscopy;
  • Level of Evidence: 4



To compare electrode array position, and depth of insertion of the Cochlear Hybrid-L24® electrode array following traditional cochleostomy and round window (RW) insertion.

Study Design:

Prospective cadaveric temporal bone study.


Ten cadaveric temporal bones were implanted with the Hybrid-L24® electrode array; half were introduced through a RW approach, whereas the other half were inserted through a traditional scala tympani cochleostomy. A micro-CT scanner was then used to evaluate electrode position, intracochlear trauma, and depth of insertion.


All electrodes were inserted into the scala tympani without significant resistance. No electrodes demonstrated tip fold-over or through-fracturing of the osseous spiral lamina, basilar membrane, or spiral ligament. The average angular depth of insertion for all 10 electrodes was 252.4°. Compared to cochleostomy insertions, electrodes inserted through the RW more commonly acquired a proximal perimodiolar orientation, followed a more predictable course, and less commonly contacted critical soft tissue structures.


The results of this study demonstrate that the Hybrid-L24® electrode can be successfully inserted using a RW or traditional cochleostomy technique with minimal intracochlear trauma. Our data also suggests that with this model, RW insertions may provide particular advantages with respect to hearing preservation over the traditional cochleostomy approach. Laryngoscope, 2011