Objectives: Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing.
Study Design: Retrospective review.
Setting: Tertiary otologic center.
Patients: Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array.
Interventions: CI, intraoperative computed tomography (CT) OUTCOME MEASURES:: Audiologic measures (consonant-nucleus-consonant [CNC] words, AzBio sentences, low-frequency pure tone averages [LFPTA]) and electrode location (scalar location, electrode-to-modiolus distance ((Equation is included in full-text article.)), angular insertion depth).
Results: Twenty-four adults with less than 80 dB LFPTA with a precurved electrode array inserted using an external sheath; 16 underwent intraoperative CT. LFPTA was 58.5 dB HL preoperatively, with a 17.3 dB threshold shift at CI activation (p = 0.005). CNC word scores improved from 6% preoperatively to 64% at 6 months postoperatively (p < 0.0001). There was one scalar translocation and no tip fold-overs. The average angular insertion depth was 388.2 degrees, and the average (Equation is included in full-text article.)across all electrodes was 0.36 mm. Multivariate regression revealed a significant correlation between CNC scores at 6 months and angular insertion depth (p = 0.0122; r = 0.45, adjusted r = 0.35). Change in LFPTA was not significantly associated with angular insertion depth or (Equation is included in full-text article.).
Conclusions: A low rate of translocation allows a precurved electrode array inserted using an external sheath to maintain hearing preservation rates comparable to straight electrode arrays. With scala tympani insertion, angular insertion depth is a positive marker of improved speech performance postoperatively but may be a confounder variable based on individual cochlear size.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910978 | PMC |
http://dx.doi.org/10.1097/MAO.0000000000002426 | DOI Listing |
JAMA Otolaryngol Head Neck Surg
December 2024
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
Importance: Speech recognition outcomes with a cochlear implant (CI) are highly variable. One factor suggested to correlate with CI-aided speech recognition is frequency-to-place mismatch, or the discrepancy between the natural tonotopic organization of the cochlea and the electric frequency allocation of the CI electrodes within the patient's cochlea.
Objective: To evaluate the association between frequency-to-place mismatch and speech recognition outcomes in a large cohort of postlingually deafened adult CI users, while controlling for various clinical factors known to be associated with those outcomes.
Eur Arch Otorhinolaryngol
November 2024
ENT Institute and Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, 20031, China.
Otol Neurotol
August 2024
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
Objectives: To assess the clinical utility of spread of excitation (SOE) functions obtained via electrically evoked compound action potentials (eCAP) to 1) identify electrode array tip fold-over, 2) predict electrode placement factors confirmed via postoperative computed tomography (CT) imaging, and 3) predict postoperative speech recognition through the first year post-activation in a large clinical sample.
Study Design: Retrospective case review.
Setting: Cochlear implant (CI) program at a tertiary medical center.
Sci Rep
March 2024
School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
PLoS One
March 2024
Cambridge Hearing Group, University of Cambridge, Cambridge, United Kingdom.
Background: Extrusion of electrodes outside the cochlea and tip fold overs may lead to suboptimal outcomes in cochlear implant (CI) recipients. Intraoperative measures such as Trans-Impedance Matrix (TIM) measurements may enable clinicians to identify electrode malposition and direct surgeons to correctly place the electrode array during surgery.
Objectives: To assess the current literature on the effectiveness of TIM measurements in identifying extracochlear electrodes and tip fold overs.
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