electrode failures (electrode migration, misplacement, etc.,)

[jamesluk]

I have bilateral CI. My first implant (Mi1000 MED_EL CONCERT, Flex 28 on left ear) was successful but the second implant is not working from day one. It has sound but little speech recognition (about 11%). The sound is very high pitched as test shows that electrode number 11 and 12 are drawing high current and had to be disabled for mapping. In addition, CT scan showed that the bad ear has the electrode array inserted to the middle of the cochlear not at the apical area. Not sure if this is electrode migration. I am looking into redoing the implant. Do anyone have the same problem and share the experience? Thank you.

 

James Luk

[Mary Beth]

Hi James,

 

I am so sorry to read about the problems you are having with your second CI.  It sounds like your CI team is actively looking into it.  I wish you the best and hope this gets resolved quickly.

[hadron]

Hi James,

Many CI users including myself have electrode 12 turned off.

Intraoperative impedance testing was probably normal but Neural Response Telemetry (NRT) was probably measured only in the basal electrodes and absent in the apical electrodes.

It probably is more likely electrode misplacement than migration.

Did you suffer any vestibular side effects?

The CT scan will show where the electrode was finally placed. It may have missed the round window and ended up in somplace like the vestibule.

[Mary Beth]

Hadron made a good point about placement rather than migration.  Since this has been an issue right from the start, it may be related to the elctrode's placement.  When I think of electrode migration, I think of an electrode that has moved out of its original location in time.  

What is the next step with your CI team?

[David]

Hadron,

Do you also have the Flex 28 electrode?

[hadron]

Hi David,

No. I have the older 31 mm standard electrode array.

Your previous post discussed the activation of the second microphone. Do you know when users will get the firmware upgrade? I believe US users are the ones waiting.

[jamesluk]

I have Flex-28.

[Mary Beth]

David,

 

I have a flex28 in my left side.

[Adam]

I agree with Mary Beth. 

As far as what I have learned, migration usually happens over time. Also based on the anatomy of the cochlea, the surgeon might not have been able to get CCC

your best best is to keep in close contact with your surgical team. I am very sorry that you have had to go through this. Hoping that you and your doctors can figure out the best course of action. 

[David]

Hadron,

Thanks, and also thanks to jamesluk, Mary Beth & Adam.

On February 2, I was informed the second microphone approval is "imminent.'

I reside in the US (Missouri) and have a left side Sonnet processor with a Synchrony implant and Flex 24 electrode array since July, 2015. The results have been outstanding.

At the time, I wanted a Flex 28 array, but the Otolaryngology surgical group would not perform Flex insertions above 24mm. Their position has since changed.

This week, I will schedule the procedure for a right side implant between mid-March to late April. I have researched, and fully understand, the risks attributed to longer array length insertions, but still prefer the Flex 28.

[David]

Hadron,

Thanks, and also thanks to jamesluk, Mary Beth & Adam.

On February 2, I was informed the second microphone approval is "imminent.'

I reside in the US (Missouri) and have a left side Sonnet processor with a Synchrony implant and Flex 24 electrode array since July, 2015. The results have been outstanding.

At the time, I wanted a Flex 28 array, but the Otolaryngology surgical group would not perform Flex insertions above 24mm. Their position has since changed.

This week, I will schedule the procedure for a right side implant between mid-March to late April. I have researched, and fully understand, the risks attributed to longer array length insertions, but still prefer the Flex 28.

[hadron]

Hi David,

Glad you are doing well.

Did your audiologist i inform you about the second Mic availability?

Good luck with the second surgery.

[Mary Beth]

Hadron,

 

The FDA site listed an approval for the Sonnet, Sonnet EAS and Maestro 6 approved 2/16/2017.  Just showed up on its site today.

[Adam]

Hadron, nothing on the 2nd mic officially as of yet. I have heard rumblings that the 2nd mic approval could be much closer than we know it.

[MED-EL Moderator]

On 2/17/2017 at 6:21 PM, jamesluk said:

I have bilateral CI. My first implant (Mi1000 MED_EL CONCERT, Flex 28 on left ear) was successful but the second implant is not working from day one. It has sound but little speech recognition (about 11%). The sound is very high pitched as test shows that electrode number 11 and 12 are drawing high current and had to be disabled for mapping. In addition, CT scan showed that the bad ear has the electrode array inserted to the middle of the cochlear not at the apical area. Not sure if this is electrode migration. I am looking into redoing the implant. Do anyone have the same problem and share the experience? Thank you.

 

James Luk

Hi James, thanks for reaching out to the HearPeers community and I'm sorry to hear about your frustrations. I strongly recommend getting in contact with your medical professional who will be able to offer you medical advice on this. I've also sent you a private message with further information. Kind regards, Leigh

[David]

Hadron,

Not from my audiologist, but a reliable source. Many thanks for your good luck wishes.

Mary Beth & Adam,

I also saw the PMA yesterday. It included an FDA statement that approval order P000025-S089 should be issued, but I was unable to determine if 0089 covered the second microphone.

[Jdashiell]

I had a similar related issue.

My first CI (Right side) last year was perfect. This year when I received an implant on my left ear, the implant either slipped or was not able to be fully inserted into the cochlea. only 7 of 12 electrodes made it in. Activation revealed the issue. A second surgery was attempted to resolve the issue, but on 5 of 12 electrodes were able to be inserted. Activation #2 is scheduled for next week, 6/22. The plan is to see how well I adapt to the 5 electrodes. A third surgery is an option after we wait and see how I progress.

I am interested to know of others that have had multiple attempts to get implanted properly.

[jamesluk]

I had a revision surgery in late April and my doctor took pictures and it was verified that 2 electrodes were out of the cochlear window. The new implant is 100% inserted and I am waiting for activation this fall because I am travelling. Thank you for your post.

[Mary Beth]

James,

I am happy to read that all the electrodes are inside your cochlea!  Enjoy your traveling.  Please let us know how activation goes in the fall.  Wishing you the best.

[Jdashiell]

best of luck this fall.

[Hila]

Hi James and everyone, 

I just found out my electrodes flex28 were not inserted past the first curve of the cochlea. I'm facing a revision surgery and I can only hope proper insertion would bring me better speech perception which I wasn't able to achieve with the situation as it is right now.  If anyone have input or would like to share their experience,  I'd love to read.  Many thanks!

[Mary Beth]

@Ivana Marinac

[Mary Beth]

@Jdashiell

How are things going for you?  Will you need another surgery?

[Jdashiell]

Hi Mary Beth 

thanks for asking 

i am seeing another surgeon to evaluate future options.

i am scheduled to get another CT scan and meet with him to see what else to do from there, MRI or what.

I am feeling positive and hopeful.

as it stands now my right ear CI is my life . My left CI is not improving and is stuck at 6 of 12 electrodes in the cochlea. Makes all sound high pitched and buzzing 

i am really hopefull that a brighter future lies ahead. 

Joe

[Mary Beth]

Joe,

 

I commend your spirit in dealing with your second CI experience.  I wish you the absolute best and am happy to hear that you are scheduled with another surgeon to explore options.  I will be rooting for you!