title: Cochlear implantation: strategies to protect the implanted cochlea from middle ear infection.
abstract: A cochlear implant for use in children must take into account the high incidence of middle ear infection in this age group. A scala tympani electrode that traverses the middle ear and round window will likely act as a conduit by which infection can spread to the inner ear and potentially to the CNS. In this study an attempt was made to reestablish a separation of the cochlea from the middle ear by developing a seal around the implant at the level of the round window. A series of cats were implanted with simulated cochlear prostheses consisting of either a plain Silastic cylinder, a Silastic cylinder wrapped with autogenous fascia, or a Silastic cylinder with a cuff of bioactive ceramic. Middle ear infection was induced, followed by histologic examination. Bioactive ceramic appears to have some merit as a round window sealing material, while fascia was shown to be of no value. Intracochlear infection, when it did occur, was limited to the basal regions of the cochlea.
mesh_terms: D000818:Animals; D002415:Cats; D002516:Ceramics; D003051:Cochlea / Q000473:pathology / Q000601:surgery*; D003054:Cochlear Implants; D004867:Equipment Design; D005205:Fascia; D007759:Labyrinth Diseases / Q000473:pathology / Q000517:prevention & control*; D008954:Models, Biological; D010033:Otitis Media / Q000150:complications* / Q000473:pathology; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers