Spiral ganglion cells, located in the cochlear modiolus, are widely thought to be the neural elements stimulated by cochlear implants (CIs). Positioning CI electrodes adjacent to the modiolus may allow delivery of more focused, discrete fields of electrical stimulation, reducing both current requirements and the channel interaction associated with simultaneous stimulation. In order to provide greater consistency in positioning CI electrodes against the modiolus, Advanced Bionics Corporation has designed a silicone intracochlear positioner that is inserted alongside the electrode. Placed against the outer wall of the scala tympani, it directs the electrode array toward the modiolus. Five fresh-frozen temporal bones were studied to validate enhanced electrode placement. Electrode position was documented with image-enhanced digital fluoroscopy, and the distance to the modiolus was measured with computer-assisted morphometrics. The electrode positioner was highly effective in positioning the electrodes closer to the modiolus (p < .001).
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