TAILIEUCHUNG - Cochlear Implants: Fundamentals and Application - part 3

Mặc dù không có sự khác biệt có ý nghĩa thống kê giữa fascia và Gelfoam, nó được khuyến cáo rằng fascia và không Gelfoam được sử dụng. Gelfoam đã được sử dụng trong các mô hình động vật để sản xuất các phương tiện truyền thông viêm tai giữa như đã mô tả trước đây. | 136 3. Surgical Pathology Figure . a photomicrograph of the basal turn of the cat cochlea where the electrode entry through the round window membrane was grafted with fascia and an otitis media was induced with Streptococcus pneumoniae. This has formed a fibrous tissue sheath or type 1 seal. ET electrode track. mococcal otitis media but there was a reduced incidence of infection when the entry point was grafted. Therefore for safety it is essential to place a graft around the electrode where it enters the cochlea. Although there was no statistically significant difference between fascia and Gelfoam it is recommended that fascia and not Gelfoam be used. Gelfoam was used in the animal models to produce otitis media as described previously. if bacteria are introduced at surgery with Gelfoam around the electrode entry point it could act as a home nidus for infection Clark and Shepherd 1997 . These experimental results apply to the Nucleus free-fitting array only. It must be stressed that a two-element array with members close to each other should not pass from the middle to the inner ear. A space between them is a conduit for infection a home to allow pathogens to multiply as well as a site to increase the pathogenicity of the organisms and reduce the ingress of antibodies and antibiotics. This is especially important considering the above studies showing the invasiveness of S. pneumoniae. Host Factors and Foreign Bodies Implanted foreign bodies as discussed above see Biocompatibility of Materials are not totally inert and should be evaluated for tissue toxicity. Foreign bodies markedly increase the pathogenic potential of organisms of low virulence for Infection 137 example Staphylococcus epidermidis Lowy and Hammer 1983 . Many studies have shown that a bacterial inoculum that is normally subinfective will lead to a severe infection in the presence of implanted material such as devitalized and crushed muscle and gelatin Vaudaux et al 1994 . Finally on the basis of

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