Using a remote network connection for intraoperative objective measurements is an efficient and safe way to perform measurements during cochlear implantation surgery.
Cochlear implantation (CI) is an effective method of treating the patients with severe hearing loss and deafness. CI is a complex of measures, including three main stages: selection of candidates, surgical stage and postoperative auditory rehabilitation, which does not always feature with positive results. The indicator of the efficacy of auditory and verbal rehabilitation after CI is the reduction of the auditory threshold and the improvement of speech intelligibility, as well as the subjective sense of sound quality with the implant. The auditory rehabilitation in adult patients was assessed in the previous studies taking into account the sex, age and duration of deafness, whereas the effect of the etiologic factor was not considered. This circumstance has predetermined the objective of this study.
Cochlear implantation is a high-tech method of rehabilitation of persons with complete deafness. However, cochlear implantation in patients may be accompanied by a number of difficulties due to the peculiarities of the structure of the cochlea, the relative position of anatomical structures relative to it and the nature of the acquired pathology of the inner ear. The reaction of the facial nerve during stimulation of one of the electrodes of the cochlear implant system is a common complication that can lead to a deterioration in the patient’s quality of life due to significant discomfort and restrictions on the use of the cochlear implant system. The debut of twitching of facial muscles in patients after cochlear implantation can occur both at the stage of connecting the speech processor and at the stages of further rehabilitation, which according to world literature can reach an interval of 10 years from the moment of surgery. Anatomical features of the cochlea, its interposition with the facial nerve, changes in the bone labyrinth, further progression of remodeling or ossification of the cochlea play a significant role in the development of symptoms of facial nerve stimulation in patients with sensorineural hearing loss of the IV degree, including at the stage of subsequent settings of the speech processor. The frequency of occurrence of this complication in various literature sources varies from 1 to 14.9 %. The purpose of this work is to review the world literature on the etiology of facial nerve stimulation in users of cochlear implants, highlighting the main theories of the origin of non-auditory sensations in this category of patients, since the data conducted in various studies are variable, and with a certain etiology reaches 38 %.
The mode of the introduction of the active electrode of a cochlear implant into the cochlea remains a key issue as far as cochlear implantation is concerned. Especially much attention has recently been given to the relationship between the anatomical features of the basal region of the cochlea (the so-called 'fish hook') and the possibility to approach it. We have undertaken the attempt to optimize the approach to the tympanic canal (scala tympanica) of the cochlea with a view to reducing to a minimum the risk of an injury to the cochlear structures in the course of cochlear implantation. A total of 35 cadaveric temporal bones were examined to measure the fine structures of the hook region and evaluate the risk of their damages associated with various approaches to the tympanic canal.
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