• Hung Kha and Bernard Chen.
• College of Engineering and Computer Science, Australian National University, Acton, Canberra, Australia. hung.kha@anu.edu.au
• Otol. Neurotol. 2012 Sep 1; 33 (7): 1176-80.

HypothesisThis study aims to examine the mechanism of damage to the basilar membrane caused by the proximal section of the cochlear implant electrode array.BackgroundThe electrode array has been found to severely damage the basilar membrane. Most previous studies on cochlear implant insertion damage largely focused on the injury by the front section (tip) of the electrode array to the membrane. Little attempt has been made to investigate the damage caused by the array's proximal section.MethodsA computational model using the finite element method has been developed for assessing the likelihood of the damage based on two criteria: 1) frequency of contact between the proximal section of the electrode array and the upper wall of the scala tympani where the basilar membrane is located, and 2) magnitude of the associated shear stresses at the contact areas. The model has been validated and used for studying the effect of electrode array's stiffness properties on the damage.ResultsThe proximal section of the contour array is most likely to hit the basilar membrane, compared with its previous versions (the straight array and the single wire electrode). In terms of shear stress magnitude, the proximal section of the contour array exerts higher stresses on the scala tympani's upper wall and, thus, is more likely to damage the basilar membrane, compared with that of the straight array.ConclusionResults from this study are useful for cochlear implant surgeons in better understanding the mechanism of damage by the electrode array's proximal section to the basilar membrane and in establishing advanced insertion techniques for reducing the damage (in particular, the results strongly support the "advance off-stylet" technique). The outcomes of the study also are beneficial for cochlear implant designers in selecting appropriate stiffness profiles for future electrode arrays, which are expected to cause minimal damage to the basilar membrane (a new design of the contour array with stiffness increasing from the front to the proximal section is highly recommended).

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