First clinical experience with the Fibrotic Obliteration Probe - a new instrument to support CI implantation in fibrosis of the cochlea

Introduction Anatomical malformations, obliterations of the cochlea or reimplantations pose particular challenges in CI care. Treatment methods include incomplete insertion, implantation of a double array and radical cochleostomy. MED-EL has developed a Fibrotic Obliteration Probe (FOP) based on the geometry of the MED-EL standard electrode. We examined retrospectively at our clinic whether the use of FOP is a new and safe procedure in CI surgery for a fibrotically altered cochlea?

Method From August 2015 to March 2019 33 patients were implanted with Flex electrodes after previous dilation of the fibrosed cochlea with the FOP and compared with a control group (K). As a third group, 8 patients with split array (SA) were included. The clinical symptoms of vertigo (V), tinnitus (T) and facial nerve stimulation (F) were compared; the impedances and speech understanding.

Results Preoperative compared to postoperative (pre / post) had FOP: V (8/7), T (12/4) & F (2/1), SA: V (1/1), T (5/4) & F (0/2) and K: V (7/4), T (9/6) & F (0/1). The impedances in kW for FOP / SA / K were intra-OP (5/5/5) and after 12 months (8/11/6). In the Freiburg monosyllable test after 6 months at 65dB, FOP / SA / K reached 28/0 / 56 in % .

Conclusions The analysis of clinical symptoms did not show a higher risk profile after using the FOP. The course of the impedances suggests greater trauma with the FOP compared to the control group, but less than with the SA. In this way, after using the FOP, patients achieve an open understanding of speech despite pre-existing cochlear pathology.

Clinically FOP is a safe instrument for dilation of a fibrotic cochlea in order to be able to insert CI electrodes.

Poster-PDF A-1547.pdf

Publication History

Article published online:
13 May 2021