Precurved Cochlear Implants and Tip Foldover: A Cadaveric Imaging Study

UMMS Affiliation

Department of Otolaryngology; School of Medicine; Senior Scholars Program

Faculty Mentor

Aaron Remenschneider

Publication Date


Document Type



Medical Education | Otolaryngology | Otorhinolaryngologic Diseases


Objective: This study aims to define a reliable protocol for radiographic identification of placement and tip foldover of newly designed precurved and straight electrodes.

Study Design: Prospective imaging study.

Setting: Academic institution.

Methods: Three models of cochlear implants (Cochlear, MED-EL, and Advanced Bionics) were inserted into fresh cadaveric specimens (n = 2) in 3 configurations (normal positioning in the scala tympani, intracochlear tip foldover, and placement into the vestibular system) for a total of 9 implant scenarios. Specimens were imaged with plain radiography in Stenvers projection, as well as by high-resolution computed tomography.

Results: Electrode placement and presence or absence of electrode tip foldover were easily identified in all 9 scenarios on plain radiography based on the described technique. Each was confirmed with high-resolution computed tomography. Plain film temporal bone images of new electrode designs with proper and improper placement are provided for reference.

Conclusion: A defined protocol for intraoperative plain film radiography allowed for reliable imaging of 3 newly designed cochlear implant electrodes and immediate identification of extracochlear placement and tip foldover. Findings may be used for intraoperative confirmation of electrode array placement.


cochlear implantation, intraoperative radiography, perimodiolar electrode, tip foldover

DOI of Published Version



Trakimas DR, Kozin ED, Ghanad I, Barber SR, Curtin H, Remenschneider AK. Precurved Cochlear Implants and Tip Foldover: A Cadaveric Imaging Study. Otolaryngol Head Neck Surg. 2018 Feb;158(2):343-349. doi: 10.1177/0194599817738978. Epub 2017 Oct 31. PMID: 29086634. Link to article on publisher's site

Journal/Book/Conference Title

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery


Danielle Trakimas participated in this study as a medical student in the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID