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Almost everything else, such as bedside manner, number of papers published, or standing in the community, is no more than mere window dressing.With CI’s, there is no 30 Day Return privilege, so choosing wisely at every step of the process is vitally important for the best outcome.
However, when you cut to the proverbial chase, it comes down to the “touch” in the surgeon’s fingertips as s/he threads the inch-long flexible electrode resembling a wet noodle into the pea-sized hearing organ without making hash of the delicate structures inside, let alone folding over or kinking the electrode array.
Unfortunately, the CI manufacturers’ patient reps — as nice as they are to get you to select their brand — will give you This even extends to when there is a problem during MAPping: The patient reps & tech support audiologists are not allowed to touch the MAPping computer, lest s/he offends the audiologist’s delicate ego, instead looking over her shoulder “suggesting” changes.
There is some effort to gather “tribal knowledge” amongst the various facilities by the Association for the Advancement of Medical Instrumentation (AAMI) into a sort of “standards” or “best practices” document.
[6/12/2015] To clarify, it’s the combination of the inability of the Contour array to be reloaded onto the stylet . Cochlear Americas’ not honoring their warranty if the surgeon kinks the electrode which conspire to cause 85% of surgeons to improperly insert the stylet too deep risking trauma.
Here is an example of an improperly placed Advanced Bionics Hi Focus 1j electrode that was folded between the 3rd & 4th electrodes during placement.
Click to enlarge in a new window that the implant be booted up in the OR by the audiologist with a cleaning cycle and an impedance check performed: This takes about 10 minutes but is necessary to detect electrical problems.