{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:14:21Z","timestamp":1767863661388,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Human otopathology following drill\u2010out procedures for cochlear implantation (CI) in cases with labyrinthitis ossificans (LO) has not been previously described. This study uses the high sensitivity of histopathology to (1) evaluate surgical drill\u2010out technique with associated intracochlear findings and (2) quantify spiral ganglion neuron populations in a series of patients with LO who underwent CI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective otopathology study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Otopathology laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Temporal bone (TB) specimens from cases with evidence of preoperative intracochlear fibroossification that required a drill\u2010out procedure for CI electrode array insertion were included. All cases were histopathologically evaluated and 3\u2010dimensional reconstructions of the cochleae were performed to interpret drilling paths and electrode trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five TB specimens were identified, of which 4 underwent drill\u2010out of the basal turn of the cochlea and 1 underwent a radical cochlear drill\u2010out. In multiple TBs, drilling was imprecise with resultant damage to essential structures. Two TBs showed injury to the modiolus, which was associated with substantially decreased or even absent neuronal populations within these areas. In addition, 2 cases with inadequate drill\u2010out or extensive LO of the basal turn resulted in extracochlear placement of electrode arrays into the vestibule due to persistent obstruction within the basal turn.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Otopathology highlights the challenges of drill\u2010out procedures in cases of LO. Imprecise drilling paths, due to distortion of normal cochlear anatomy, risk injury to the modiolus and adjacent neurons as well as extracochlear placement of electrode arrays, both of which may contribute to poorer hearing outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599819847636","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T15:12:48Z","timestamp":1557241968000},"page":"658-665","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Human Otopathology of Cochlear Implant Drill\u2010out Procedures"],"prefix":"10.1002","volume":"161","author":[{"given":"Danielle R.","family":"Trakimas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Boston Massachusetts USA"},{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts USA"},{"name":"University of Massachusetts Medical School Worcester Massachusetts 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