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Stability of the cochlear implant array in children
Authors:J Thomas Roland  Andrew J Fishman  Susan B Waltzman  George Alexiades  Ronald A Hoffman  Noel L Cohen
Abstract:Objective: To determine cochlear implant electrode stability in the young patient. Electrode migration due to future skull growth was a concern that led to prohibiting implantation in children less than 2 years of age. Recently, the high level of performance achieved by young implantees has led to a re-evaluation of this lower age limit, requiring an assessment of the effects of skull growth over time. Study Design: Prospective radiographic analysis of electrode position of cochlear implants in young children. Methods: Twenty-seven children implanted with the Nucleus (Cochlear Corp., Denver, CO) or Clarion (Advanced Bionics Inc., Sylmar, CA) multichannel cochlear prostheses were subjects for this study. Follow-up radiographic studies were obtained for a period of 1 month to 5 years after implantation. The age at time of implantation ranged from 14 months to 5 years. An intraoperative modified Stenver's view plain radiograph was obtained as a baseline. After implantation, on a yearly basis transorbital Stenver's and base views were obtained for comparative purposes. Additional radiographs were obtained whenever a change in performance or electrode map caused suspicion for extrusion. Electrode position was determined using a computer graphics enhancement technique whereby image contrast filters enhanced the visibility of the electrode array and surrounding bony structures. Results: An analysis of the data revealed no migration of the electrode array over time. Conclusions: The confirmation of the stability of the electrode array alleviates the concern of the effects of skull growth on cochlear implantation in young children.
Keywords:Cochlear implant  electrode extrusion  pediatric  deafness  radiologic imaging
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