Evaluating a New Software (OTOGUIDE) to Help Monitor Electrode Insertion During Cochlear Implant Surgery. (OGUID)

Monitoring Electrode Insertion During Cochlear Implant Surgery With OTOGUIDE

Cochlear implants are a successful treatment for severe hearing loss in both children and adults. The procedure involves placing an electrode array into the cochlea to stimulate the auditory nerve, helping patients to hear. For the best results, it's crucial to place the electrode precisely and gently to avoid damaging delicate structures inside the ear. However, currently, surgeons lack feedback on the insertion status, making it difficult to confirm correct electrode positioning, especially regarding insertion depth, such as angle, frequency, or millimeters. New technologies are being developed to provide feedback during surgery, helping surgeons place the electrode more accurately. One such technology, recently developed by MED-EL, is called OTOGUIDE. This software offers immediate information on the electrode's position and functioning during the operation, aiming to improve surgical precision and hearing outcomes.

This clinical investigation aims to evaluate the performance and safety of OTOGUIDE, which assists surgeons during cochlear implant procedures by helping identify the position and angle of electrode contacts placed inside the cochlea. The primary objective is to confirm that OTOGUIDE can accurately detect which electrodes are inserted into the cochlea, with results that are more than 80% consistent with standard CT imaging (either during or after surgery). The secondary objective is to verify that OTOGUIDE can estimate the insertion angle of a specific electrode (C1) with a margin of error smaller than 60 degrees compared to CT imaging.

Participants who agree to take part and sign the informed consent form will undergo up to three study visit, which coincides with their scheduled routine cochlear implant surgery visits. During the Surgery Visit intraoperative measurements will be performed using both OTOGUIDE and the MAESTRO system. CT imaging (either during or after surgery, depending on routine clinical practice) will be used to verify the electrode array's position inside the cochlea.

Study Overview

• Status: Not yet recruiting
• Conditions: Cochlear Implantation; Monitoring Electrode Insertion
• Intervention / Treatment: Device: OTOGUIDE software

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jasmine Rinnofner; Phone Number: +43577881694; Email: jasmine.rinnofner@medel.com

Study Locations

• Austria
  • Tyrol
    • Innsbruck, Tyrol, Austria, 6020
      • Medizinische Universität Innsbruck
      • Contact: Joachim Schmutzhard, Prof. Dr. med.; Phone Number: +43 512 504 23141; Email: Joachim.Schmutzhard@i-med.ac.at
• Germany
  • Bavaria
    • Munich, Bavaria, Germany, 81377
      • Klinikum der Universität München, Campus Großhadern Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde
      • Contact: Florian Simon, Dr.med.; Phone Number: +49894400-81449; Email: florian.simon@med.uni-muenchen.de

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Minimum age of eighteen (18) years at time of enrolment.
• Subjects to be implanted with a compatible MED-EL cochlear implant (CI) (Mi1200 SYNCHRONY (PIN), Mi1210 SYNCHRONY ST, Mi1250 SYNCHRONY 2 (PIN), Mi1260 SONATA 2) according to clinical routine.
• Signed and dated informed consent before the start of any study-specific procedure.

Exclusion Criteria:

• Previously having received a CI on the ear to be tested (Re-implantation).
• Evidence of ossification or any other cochlear anomaly (e.g., malformation) that might prevent complete insertion of the electrode array or might cause increased risk of infection (e.g. dysplastic cochlear), as confirmed by medical examination and/or as per CT/MRI.
• Known absence of cochlear development or if the cause of deafness is non-functionality of the auditory nerve and/or the upper auditory pathway.
• Evidence of active external or middle ear infection or history of recurrent middle ear infection in the ear to be implanted.
• Acute cholesteatoma
• The tympanic membrane is perforated in the ear to be implanted.
• Pre-existing condition known to prohibit CT imaging before and after cochlear implantation.
• Women being pregnant or nursing.
• Anything that, in the opinion of the Investigator, would place the subject at increased risk or preclude the subject's full compliance with or completion of the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Monitoring electrode insertion with OTOGUIDE; Monitoring electrode insertion with OTOGUIDE during routine cochlear implantation

Device: OTOGUIDE software; OTOGUIDE performs objective measurements to enable the monitoring of the electrode insertion and the functioning of the electrode. OTOGUIDE guides the users through a workflow-based session to assess the implant status and to define a surgical approach. The users can plan an insertion target and monitor the real-time electrode insertion using an impedance-based method to automatically detect the number of contacts inside the cochlea.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of inserted electrodes	The primary endpoint is the agreement rate between OTOGUIDE and intra- or post-operative CT imaging in detecting which contacts in an electrode array are inserted and which are not inserted in the cochlea.	through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Insertion angle of C1 electrode contact	The secondary endpoint is the deviation (i.e., the absolute difference) between the insertion angle for the C1 electrode contact estimated by OTOGUIDE and the insertion angle as assessed with intra- or post-operative CT imaging.	through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Deviation in Hz of the frequencies allocated to C1 - C12 electrode contacts	Deviation in Hz of the frequencies allocated to C1 - C12 electrode contacts as estimated by OTOGUIDE and the allocated frequencies as assessed with CT imaging	through study completion, an average of 1 year
Deviation in degree of the insertion angles of C2 - C12 electrode contacts	Deviation in degree of the insertion angles of C2 - C12 electrode contacts estimated by OTOGUIDE and the insertion angles as assessed with intra-or post-operative CT imaging	through study completion, an average of 1 year
Intra-operative impedance values	Deviation in kΩ of the intra-operative impedance values derived from OTOGUIDE and MAESTRO	through study completion, an average of 1 year
Product-specific feedback	OTOGUIDE usability and satisfaction questionnaire for clinicians	through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: MED-EL Elektromedizinische Geräte GesmbH

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): February 1, 2027

Study Registration Dates

• First Submitted: June 11, 2026
• First Submitted That Met QC Criteria: July 6, 2026
• First Posted (Actual): July 8, 2026

Study Record Updates

• Last Update Posted (Actual): July 8, 2026
• Last Update Submitted That Met QC Criteria: July 6, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: impedance; OTOGUIDE; Electrode insertion
• Other Study ID Numbers: MED-EL_CRD_2024_04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No