The aim of this study was to evaluate electrode array position in relation to cochlear anatomy and its influence on hearing performance in cochlear implantees. Twenty-two patients (25 ears) with Med-El cochlear implants were included in this retrospective study. A negative correlation was observed between electrode-modiolus distance (EMD) at the cochlear base and monosyllabic word discrimination 6 months after implantation. We found no correlation between EMD and hearing outcome at 12 months. The insertion depth/cochlear perimeter ratio appeared to negatively influence the EMD at the base. Indeed, deep insertions in small cochleae appeared to yield smaller EMD and better hearing performance. This observation supports the idea of preplanning the surgery by adapting the electrode array to the length of the available scala tympani.
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http://dx.doi.org/10.1159/000354115 | DOI Listing |
Otol Neurotol
December 2023
Department of Neurosurgery, Shandong Second Provincial General Hospital, Jinan, Shandong, 250022, China.
Objectives: The goal of this study was to use cone-beam computed tomography to locate the electrode-modiolus distance (EMD) and correlate this with speech perception in cochlear implant (CI) recipients of the 31.5-mm lateral wall (LW) electrode arrays.
Study Design: Retrospective review.
Sci Rep
July 2021
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
The slim modiolar electrode has been reported to ensure better modiolar proximity than previous conventional perimodiolar electrodes and consistently high scala tympani localization. Nonetheless, variability in modiolar proximity exists even among slim modiolar electrodes, still leaving room for further improvement of modiolar proximity, which may positively affect functional outcomes. Given this, the pull-back maneuver was reported to increase the modiolar proximity of slim modiolar electrodes in a cadaveric study, but in vivo repositioning effects remain to be established.
View Article and Find Full Text PDFTrends Hear
July 2021
Clinic for Otorhinolaryngology, Hannover Medical School, Hannover, Germany.
Amplitude growth functions (AGFs) of electrically evoked compound action potentials (eCAPs) with varying interphase gaps (IPGs) were measured in cochlear implant users with ipsilateral residual hearing (electric-acoustic stimulation [EAS]). It was hypothesized that IPG effects on AGFs provide an objective measure to estimate neural health. This hypothesis was tested in EAS users, as residual low-frequency hearing might imply survival of hair cells and hence better neural health in apical compared to basal cochlear regions.
View Article and Find Full Text PDFJ Assoc Res Otolaryngol
October 2021
Medical Research Council Cognition & Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK.
The knowledge of patient-specific neural excitation patterns from cochlear implants (CIs) can provide important information for optimizing efficacy and improving speech perception outcomes. The Panoramic ECAP ('PECAP') method (Cosentino et al. 2015) uses forward-masked electrically evoked compound action-potentials (ECAPs) to estimate neural activation patterns of CI stimulation.
View Article and Find Full Text PDFJ Assoc Res Otolaryngol
February 2021
Cambridge Hearing Group, MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 7EF, UK.
Variations in the condition of the neural population along the length of the cochlea can degrade the spectral and temporal representation of sounds conveyed by CIs, thereby limiting speech perception. One measurement that has been proposed as an estimate of neural survival (the number of remaining functional neurons) or neural health (the health of those remaining neurons) is the effect of stimulation parameters, such as the interphase gap (IPG), on the amplitude growth function (AGF) of the electrically evoked compound action potential (ECAP). The extent to which such measures reflect neural factors, rather than non-neural factors (e.
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