title: The Impact of a Cochlear Implant Electrode Array on the Middle Ear Transfer Function.
abstract: As a treatment for partial deafness with residual hearing in the lower frequency range, the combined acoustic and electric stimulation of the cochlea has become widespread. Acoustic stimulation is provided by a hearing aid's airborne sound and the electric stimulation by a cochlear implant electrode array, which may be inserted through the round window or a cochleostomy. To take advantage of that concept, it is essential to preserve residual hearing after surgery. Therefore, the intracochlear electrode array should not compromise the middle ear vibration transmission. This study investigates the influence of different electrode types and insertion paths on the middle ear transfer function and the inner ear fluid dynamics.
  
  
  
  Sound-induced oval and round window net volume velocities were calculated from vibration measurements with laser vibrometers on six nonfixated human temporal bones. After baseline measurements in the "natural" condition, a cochleostomy was drilled and closed with connective tissue. Then, four different electrode arrays were inserted through the cochleostomy. Afterwards, they were inserted through the round window while the cochleostomy was patched again with connective tissue.
  
  
  
  After having drilled a cochleostomy and electrode insertion, no systematic trends in the changes of oval and round window volume velocities were observed. Nearly all changes of middle ear transfer functions, as well as oval and round window volume velocity ratios, were statistically insignificant.
  
  
  
  Intracochlear electrode arrays do not significantly increase cochlear input impedance immediately after insertion. Any changes that may occur seem to be independent of electrode array type and insertion path.
authors.affiliation: 1Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany; and 2Jean Uhrmacher Institute for Clinical ENT-Research, University of Cologne, Cologne, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Pazen
authors.forename: Andreas
authors.initials: A
authors.lastname: Anagiotos
authors.forename: Maike
authors.initials: M
authors.lastname: Nünning
authors.forename: Antoniu-Oreste
authors.initials: AO
authors.lastname: Gostian
authors.forename: Magdalene
authors.initials: M
authors.lastname: Ortmann
authors.forename: Dirk
authors.initials: D
authors.lastname: Beutner
mesh_terms: D000161:Acoustic Stimulation; D003051:Cochlea / Q000601:surgery*; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004432:Ear, Middle / Q000503:physiopathology; D004558:Electric Stimulation; D006310:Hearing Aids; D034381:Hearing Loss / Q000534:rehabilitation*; D006801:Humans; D010046:Oval Window, Ear / Q000503:physiopathology*; D011184:Postoperative Period; D012405:Round Window, Ear / Q000503:physiopathology*