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Navigating the challenges of misplaced electrode array in cochlear implant surgery: causes, consequences and solutions

Published online by Cambridge University Press:  02 April 2025

Mohnish Grover Open the ORCID record for Mohnish Grover [Opens in a new window] ,
Tanmaya Kataria Open the ORCID record for Tanmaya Kataria [Opens in a new window] ,
Sunil Samdani ,
Gaurav Gupta ,
Raghav Mehta  and
Mukesh Dagur
Mohnish Grover
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, RJ, India
Tanmaya Kataria*
Affiliation:
Department of Otorhinolaryngology, Mahatma Gandhi Medical College, Jaipur, RJ, India
Sunil Samdani
Affiliation:
Department of Otorhinolaryngology, SMS Medical College, Jaipur, RJ, India
Gaurav Gupta
Affiliation:
Department of Otorhinolaryngology, SP Medical College, Bikaner, RJ, India
Raghav Mehta
Affiliation:
Department of Otorhinolaryngology, RUHS College of Medical Sciences, Jaipur, RJ, India
Mukesh Dagur
Affiliation:
Department of Otorhinolaryngology, RDBP Jaipuria Hospital, Jaipur, RJ, India
*
Corresponding author: Tanmaya Kataria; Email: tanmayakataria@gmail.com
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Abstract

Objectives

Cochlear implantation is a groundbreaking surgical procedure offering significant benefits to individuals with severe hearing impairments. Correct placement of the electrode array within the cochlea is crucial for optimal device functionality and auditory outcomes. Our study describes four cases of electrode misplacement along with the factors causing it and discusses solutions for the same.

Methods

Eight hundred cochlear implant cases were reviewed in three tertiary care centres in India, spanning 2011 to 2023.

Results

Four cases of electrode misplacement requiring reimplantation were identified.

Conclusion

This paper discusses the implications of electrode misplacement, the factors contributing to it and the critical role of multidisciplinary approaches in managing such complications. By addressing these issues, we aim to improve surgical techniques and outcomes in cochlear implant procedures.

Keywords

Cochlear ImplantationElectrode misplacementComplications

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 8 , August 2025 , pp. 745 - 751
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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References

Webb, RL, Lehnhardt, E, Clark, GM, Laszig, R, Pyman, BC, BK–HG, Franz. Surgical complications with the cochlear multiple-channel intracochlear implant: experience at Hannover and Melbourne. Ann. Otol. Rhinol. Laryngol 1991;100:131–6CrossRefGoogle ScholarPubMed
Tange, RA, Grolman, W, Maat, A. Intracochlear misdirected implantation of a cochlear implant. Acta Otolaryngolog 2006;126:650–2CrossRefGoogle ScholarPubMed
Gulya, AJ, Steenerson, RL. The scala vestibuli for cochlear implantation. Arch. Otolaryngol. Head Neck Surg 1996;122:130–2CrossRefGoogle ScholarPubMed
Waltzman, B, JT, Roland Jr. Cochlear Implants, 3rd edn. New York: Thieme, 2014Google Scholar
Lassig, AA, Zwolan, TA, Telian, SA. Cochlear implant failures and revision. Otol Neurotol 2005;26:624–34CrossRefGoogle ScholarPubMed
Marlowe, AL, Chinnici, JE, Rivas, A, Niparko, JK, Francis, HW. Revision cochlear implant surgery in children: the Johns Hopkins experience. Otol Neurotol 2010;31:74–82CrossRefGoogle ScholarPubMed
Li, PM, Wang, H, Northrop, C, Merchant, SN, JB, Nadol Jr. Anatomy of the round window and hook region of the cochlea with implications for cochlear implantation and other endocochlear surgical procedures. Otol Neurotol 2007;28:641–8CrossRefGoogle ScholarPubMed
Angeli, RD, Lavinsky, J, Setogutti, ET, Lavinsky, L. The Crista Fenestra and its impact on the surgical approach to the scala tympani during cochlear implantation. Audiol Neurootol 2017;22:50–5CrossRefGoogle Scholar
Jain, R, Mukherji, SK. Cochlear implant failure: imaging evaluation of the electrode course. Clin Radiol 2003;58:288–93CrossRefGoogle ScholarPubMed
Tange, RA, Grolman, W, Maat, A. Intracochlear misdirected implantation of a cochlear implant. Acta Otolaryngol 2006;126:650–2CrossRefGoogle ScholarPubMed
Pau, H, Parker, A, Sanli, H, Gibson, WPR. Displacement of electrodes of a cochlear implant into the vestibular system: intra-and postoperative electrophysiological analyses. Acta Otolaryngol 2005;125:1116–18CrossRefGoogle ScholarPubMed
Beltrame, MA, Frau, GN, Shanks, M, Robinson, P, Anderson, I. Double posterior labyrinthotomy technique: results in three Med-El patients with common cavity. Otol Neurotol 2005;26:177–82CrossRefGoogle ScholarPubMed
Muzzi, E, Boscolo-Rizzo, P, Santarelli, R, Beltrame, MA. J LaryngolOtol 2012;126:414–17CrossRefGoogle Scholar
Mehanna, AM, Gamaleldin, OA, Fathalla, MF. The misplaced cochlear implant electrode array. Int J Pediatr Otorhinolaryngol 2019;117:96–104CrossRefGoogle ScholarPubMed
Sharma, S, Grover, M, Singh, S N, Kataria, T and Lakhawat, RS. Cochlear orientation: pre-operative evaluation and intra-operative significance. J Laryngol Otol 2018;132:540–3CrossRefGoogle ScholarPubMed
Woolford, TJ, Saeed, SR, Boyd, P, Hartley, C, Ramsden, RT. Cochlear reimplantation. Ann Otol Rhinol Laryngol Suppl 1995;166:449–53Google ScholarPubMed
Cetin, MA, Hatipoglu, HG, Ikinciogullari, A, Koseoglu, S, Ozcan, KM, Yuksel, E, et al. The importance of carotid-cochlear interval in the etiology of hearing loss. Indian J Otolaryngol Head Neck Surg 2013;65:345–9CrossRefGoogle ScholarPubMed
Gastman, BR, Hirsch, BE, Sando, I, Fukui, MB, Wargo, ML. The potential risk of carotid injury in cochlear implant surgery. Laryngoscope 2002;112:262–6CrossRefGoogle ScholarPubMed
Muren, C, Wadin, K, Wilbrand, HF. The cochlea and the carotid canal. Acta Radiol 1990;31:33–5CrossRefGoogle ScholarPubMed
Wysocki, J, Skarzynski, H. Distances between the cochlea and adjacent structures related to cochlear implant surgery. Surg Radio Anat 1998;20:267–71CrossRefGoogle ScholarPubMed
Sennaroğlu, L, Bajin, MD. Classification and current management of inner ear malformations. Balkan Med J 2017;34:397–411CrossRefGoogle ScholarPubMed
Grover, M, Sharma, S, Preetam, C, Gupta, G, Samdani, S, Agarwal, S, et al. New SMS classification of cochleovestibular malformation and its impact on decision-making. J Laryngol Otol 2019;133:368–75CrossRefGoogle ScholarPubMed
Pau, H, Parker, A, Sanli, H, Gibson, WPR. Displacement of electrodes of a cochlear implant into the vestibular system: intra-and postoperative electrophysiological analyses. Acta Otolaryngol 2005;125:1116–18CrossRefGoogle ScholarPubMed
Ying, YL, Lin, JW, Oghalai, JS, Williamson, RA. Cochlear implant electrode misplacement: incidence, evaluation, and management. Laryngoscope 2013;123:757–66CrossRefGoogle ScholarPubMed
Copeland, BJ, Pillsbury, HC, Buchman, CA. Prospective evaluation of intraoperative cochlear implant radiographs. Otol Neurotol 2004;25:295–97CrossRefGoogle ScholarPubMed
Dirr, F, Hempel, JM, Krause, E, Müller, J, Berghaus, A, Ertl-Wagner, B, et al. Value of routine plain x-ray position checks after cochlear implantation. Otol Neurotol 2013;34:1666–9CrossRefGoogle ScholarPubMed
Fishman, AJ, JT, Roland Jr, Alexiades, G, Mierzwinski, J, Cohen, NL. Fluoroscopically assisted cochlear implantation. Otol Neurotol 2003;24:882–6CrossRefGoogle ScholarPubMed
Proops, DW, Stoddart, RL, Donaldson, I. Medical, surgical and audiological complications of the first 100 adult cochlear implant patients in Birmingham. J Laryngol Otol 1999;24(suppl):14–17CrossRefGoogle ScholarPubMed