Lessons learned in delayed identification of a misplaced electrode array in the vestibule

To report a case of cochlear implantation with a misplaced electrode array in the vestibule and the causes for the delay in identification. A 23-year-old male with left single-sided deafness underwent cochlear implantation. The intraoperative assessment did not reveal any major red flags of electrod...

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Main Authors: Huey Ting Diong, Yuhan Wong, Shermaine Png, Yeow Seng Raymond Ngo
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:Journal of Otology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1672293024000412
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author Huey Ting Diong
Yuhan Wong
Shermaine Png
Yeow Seng Raymond Ngo
author_facet Huey Ting Diong
Yuhan Wong
Shermaine Png
Yeow Seng Raymond Ngo
author_sort Huey Ting Diong
collection DOAJ
description To report a case of cochlear implantation with a misplaced electrode array in the vestibule and the causes for the delay in identification. A 23-year-old male with left single-sided deafness underwent cochlear implantation. The intraoperative assessment did not reveal any major red flags of electrode array misplacement. He did not display any vestibular symptoms postoperatively but showed poor speech performance, even though the aided tone audiometry revealed good sound detection thresholds. High-resolution computed tomography (HRCT) showed that the entire perimodiolar electrode array was situated within the vestibule, and a revision surgery was conducted. Retrospective analysis of the neural response telemetry (NRT) revealed subtle differences in responses between the misplaced and correctly placed electrode arrays. Unlike previously reported cases, the patient did not display vestibular symptoms despite the misplacement of the electrode in the vestibule due to existing weakness in otolithic function. Further investigation is warranted when a motivated patient with normal inner ear anatomy does not show benefit with the cochlear implant post-operatively.
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spelling doaj-art-71b70cea00934bd5b5033ed22261648a2024-12-11T05:55:52ZengElsevierJournal of Otology1672-29302024-10-01194241246Lessons learned in delayed identification of a misplaced electrode array in the vestibuleHuey Ting Diong0Yuhan Wong1Shermaine Png2Yeow Seng Raymond Ngo3Department of Audiology, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore; Corresponding author.Manchester Centre for Audiology and Deafness, Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom; Department of Audiology and Speech Pathology, School of Health Sciences, The University of Melbourne, 550 Swanston Street, Victoria, 3010, AustraliaDepartment of Audiology, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, SingaporeDepartment of Ear, Nose and Throat – Head and Neck Surgery, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore; Department of Otolaryngology – Head and Neck Surgery, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, SingaporeTo report a case of cochlear implantation with a misplaced electrode array in the vestibule and the causes for the delay in identification. A 23-year-old male with left single-sided deafness underwent cochlear implantation. The intraoperative assessment did not reveal any major red flags of electrode array misplacement. He did not display any vestibular symptoms postoperatively but showed poor speech performance, even though the aided tone audiometry revealed good sound detection thresholds. High-resolution computed tomography (HRCT) showed that the entire perimodiolar electrode array was situated within the vestibule, and a revision surgery was conducted. Retrospective analysis of the neural response telemetry (NRT) revealed subtle differences in responses between the misplaced and correctly placed electrode arrays. Unlike previously reported cases, the patient did not display vestibular symptoms despite the misplacement of the electrode in the vestibule due to existing weakness in otolithic function. Further investigation is warranted when a motivated patient with normal inner ear anatomy does not show benefit with the cochlear implant post-operatively.http://www.sciencedirect.com/science/article/pii/S1672293024000412Cochlear implantationElectrode misplacementVestibulePoor CI outcomeNeural response telemetry
spellingShingle Huey Ting Diong
Yuhan Wong
Shermaine Png
Yeow Seng Raymond Ngo
Lessons learned in delayed identification of a misplaced electrode array in the vestibule
Journal of Otology
Cochlear implantation
Electrode misplacement
Vestibule
Poor CI outcome
Neural response telemetry
title Lessons learned in delayed identification of a misplaced electrode array in the vestibule
title_full Lessons learned in delayed identification of a misplaced electrode array in the vestibule
title_fullStr Lessons learned in delayed identification of a misplaced electrode array in the vestibule
title_full_unstemmed Lessons learned in delayed identification of a misplaced electrode array in the vestibule
title_short Lessons learned in delayed identification of a misplaced electrode array in the vestibule
title_sort lessons learned in delayed identification of a misplaced electrode array in the vestibule
topic Cochlear implantation
Electrode misplacement
Vestibule
Poor CI outcome
Neural response telemetry
url http://www.sciencedirect.com/science/article/pii/S1672293024000412
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