Presentated at the Triological Society Annual COSM meeting, San Diego, U.S.A., April 20, 2012.
Article first published online: 8 JAN 2013
Copyright © 2013 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 123, Issue 3, pages 757–766, March 2013
How to Cite
Ying, Y.-L. M., Lin, J. W., Oghalai, J. S. and Williamson, R. A. (2013), Cochlear implant electrode misplacement: Incidence, evaluation, and management. The Laryngoscope, 123: 757–766. doi: 10.1002/lary.23665
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 26 FEB 2013
- Article first published online: 8 JAN 2013
- Manuscript Accepted: 23 JUL 2012
- Extracochlear electrode array misplacement;
- cochlear implant explantation and reimplantation;
- Level of Evidence: 4
To review the presentation and management of improper electrode array placement, and to help guide clinical decision-making.
Retrospective case series.
Pediatric and adult cochlear implant patients managed from January 2001 to present whose electrode arrays were not placed properly within the cochlea or extended beyond the cochlea into the internal auditory canal or adjacent structures.
Four patients, three pediatric and one adult, were identified from over 824 cases (< 1%) managed over the study duration. All cases had normal cochlear anatomy. These cases were initially identified due to poor auditory skill development or absent behavioral responses following implantation, which prompted imaging. Two patients presented several years after surgery. Sites of improper placement included the eustachian tube, vestibule, internal carotid artery canal, and internal auditory canal (IAC). Intraoperative findings and management are reviewed.
Electrode array malpositioning is a rare, but serious and correctable complication in cochlear implant surgery. A multidisciplinary approach, including prompt audiologic evaluation and imaging, is important, particularly when benefit from the implant is limited or absent. Management of electrode arrays in the IAC may be more challenging. Laryngoscope, 2013