title: The "pull-back" technique for Nucleus 24 perimodiolar electrode insertion.
abstract: OBJECTIVE
  To observe the influence of electrode pull-back after cochlear implant insertion of Nucleus 24 perimodiolar electrodes.
  
  
  METHODS
  In a prospective intraoperative study, we analyzed the impedances, neural response telemetry responses, and the spread of excitation after cochlear implant electrode insertion and compared these data to those obtained after a subsequent, controlled pull-back of the electrode. Postoperative depth of electrode insertion was controlled by x-ray.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Six patients (4 male, 2 female; 18 to 69 years) were implanted with a Nucleus 24 (RCA) cochlear implant with a perimodiolar electrode.
  
  
  RESULTS
  After a controlled pull-back, a significant decrease of the spread of excitation at the stimuli electrodes 5, 10, 15, and a nonsignificant decrease at stimuli electrode 20 compared to the recordings after the primary normal insertion procedure was found. The mean electric compound action potential amplitude was increased with an apical-to-basal tendency. Impedances remained unchanged by the pull-back. Mean insertion depth at the postoperative x-ray control was 372 degrees (+/- 10.2).
  
  
  CONCLUSIONS
  Controlled cochlear implant electrode pull-back is a novel technique that optimizes objective intraoperative electrophysiological recordings in patients implanted with a Nucleus 24 perimodiolar cochlear implant by a greater approximation of the electrode to the modiolus.
authors.affiliation: Department of Otolaryngology at ukb, Warener Strasse 7, D-12683 Berlin, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Todt
authors.forename: Dietmar
authors.initials: D
authors.lastname: Basta
authors.forename: Andreas
authors.initials: A
authors.lastname: Eisenschenk
authors.forename: Arne
authors.initials: A
authors.lastname: Ernst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D003638:Deafness / Q000628:therapy; D004567:Electrodes, Implanted; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies