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Mechanism underlying and prevention of electrode migration in cochlear implants

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Abstract

Purpose

We investigate the clinical manifestations, mechanisms, and methods of preventing electrode migration in Cochlear Implantation (CI) patients, based on our practical experience with this problem.

Study design

This is a retrospective study in a single center.

Methods

We retrospectively reviewed electrode migration in 4 (0.75%) of 532 patients who underwent CI at our tertiary institution from January 2002 to December 2022. Pre- and post-operative pure-tone audiometry, word recognition score, aided functional gain test, and sound field speech intelligibility test were evaluated.

Results

All four patients underwent CIs with the straight electrode type. The following events or symptoms were observed in the patients before confirming electrode migration: an increase in high-frequency thresholds during the post-operative aided functional gain test and a decline in scores on the sound field speech intelligibility test. Electrode migration was confirmed through transocular view X-ray or temporal bone computer tomography. Two patients showed coiled electrodes within the mastoid cavity; while in the others, the electrodes were observed to be floating inside the cavity. To prevent migration of electrodes due to these issues, we mixed bone paste collected during the drilling of the mastoid cavity with glue and used it to secure the electrodes in place.

Conclusion

Electrode migration can result in a decrease in hearing ability and may necessitate a revision surgery to adjust the electrode placement. The main factors affecting electrode placement include the position of electrode within the mastoid cavity and the elasticity of straight electrodes. It is important for surgeons to recognize the factors that increase the risk of electrode migration and to take preventative measures to reduce this risk.

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Data availability

Not applicable.

References

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Funding

No funding or financial relationship to declare.

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Authors and Affiliations

  1. Department of Otolaryngology, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Republic of Korea

    Jungho Ha, Hannah Park, Jisun Yang, Jeong Hun Jang, Hun Yi Park & Yun-Hoon Choung

  2. Department of Medical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea

    Jungho Ha, Hannah Park, Jisun Yang & Yun-Hoon Choung

Authors
  1. Jungho Ha
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  2. Hannah Park
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  3. Jisun Yang
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  4. Jeong Hun Jang
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  5. Hun Yi Park
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  6. Yun-Hoon Choung
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Contributions

Conceptualization: JH, YHC. Data curation: all authors. Formal analysis: JH, JY, HP. Methodology: JH, YHC. Project administration: YHC. Visualization: all authors. Writing—original draft: JH. Writing—review and editing: JHJ, HYP, YHC.

Corresponding author

Correspondence to Yun-Hoon Choung.

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Conflict of interest

No author has any conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board of Ajou University School of Medicine, Republic of Korea (approval no. AJOUIRB-EX-2023-094) and the requirement for informed consent was waived.

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Ha, J., Park, H., Yang, J. et al. Mechanism underlying and prevention of electrode migration in cochlear implants. Eur Arch Otorhinolaryngol 281, 1597–1602 (2024). https://doi.org/10.1007/s00405-023-08346-6

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  • DOI: https://doi.org/10.1007/s00405-023-08346-6

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