AI Article Synopsis
- - The study evaluated the effectiveness of a new mapping approach for a precurved cochlear implant (CI) electrode array in the internal auditory canal (IAC) of a 7-year-old child who had no speech recognition with their left CI due to anatomical malformations.
- - After applying the new mapping procedure, speech recognition for the left CI improved from 0% to 32% after one month and further to 52% after three months, while bilateral CI recognition improved from 56% to 80% in the same time frame.
- - The findings suggest that tailored mapping, based on imaging and individual responses, can enhance speech recognition outcomes for patients with challenging electrode placements, especially when surgery is not an option
Article Abstract
Objectives: Review the effectiveness of an alternative mapping procedure of a precurved electrode array in the internal auditory canal (IAC).
Design: A 7-year-old bilateral cochlear implant (CI) recipient of precurved arrays transferred to the study site and demonstrated no speech recognition with the left CI. Imaging revealed bilateral incomplete partition type III malformations. For the left CI, four contacts were observed in the basal cochlear turn and 18 contacts were coiled in the IAC. The family decided against revision surgery. Pitch ranking was completed to map the contacts in the IAC that were perceptually discrete and tonotopically organized.
Results: For the left CI, PB-K word recognition improved from no recognition to 32% after 1 month and to 52% after 3 months. In the bilateral CI condition, performance improved from 56 to 72% after 1 month and 80% after 3 months.
Conclusion: A precurved array in the IAC creates difficult management decisions. Direct stimulation of the auditory nerve resulted in better monaural and bilateral speech recognition, likely due to better spectral representation of the speech signal. Individualizing the map using imaging and behavioral findings may improve performance for malpositioned arrays when revision surgery is not pursued.
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| http://dx.doi.org/10.1097/MAO.0000000000003570 | DOI Listing |
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