Bilateral simultaneous cochlear implants in children: Best timing of surgery and long-term auditory outcomes

Franchella, Sebastiano; Concheri, Stefano; Di Pasquale Fiasca, Valerio Maria; Brotto, Davide; Sorrentino, Flavia; Ortolani, Caterina; Agostinelli, Anna; Montino, Silvia; Gregori, Dario; Lorenzoni, Giulia; Borghini, Carlotta; Trevisi, Patrizia; Marioni, Gino; Zanoletti, Elisabetta

doi:10.1016/j.amjoto.2023.104124

Cited by 2 publications

(1 citation statement)

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“…In addition, once the insertion is complete, the surgeon has immediate awareness of the average IS he employed. Simultaneous bilateral cochlear implantation, performed in our series by 24 months of age to ensure optimal audiological outcomes [ 26 ], offers the surgeon the opportunity to immediately implement adjustments based on feedback from the first side on the second side. Cochlear SmartNav aims to provide a real time IS assessment, and this value is directly visible to the surgeon.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav

Concheri,

Brotto,

Ariano

et al. 2024

Audiology Research

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Objectives: The objectives were to present the real-time estimated values of cochlear implant (CI) electrode insertion speed (IS) during intraoperative sessions using the Cochlear Nucleus SmartNav System to assess whether this measure affected CI outcomes and to determine whether real-time feedback assists expert surgeons in achieving slow insertion. Methods: The IS was measured in 52 consecutive patients (65 implanted ears) using the CI632 electrode. The IS values were analyzed in relation to procedure repetition over time, NRT ratio, and CI audiological outcomes. Results: The average IS was 0.64 mm/s (SD = 0.24); minimum and maximum values were 0.23 and 1.24 mm/s, respectively. The IS significantly decreased with each array insertion by the operator (p = 0.006), and the mean decreased by 24% between the first and last third of procedures; however, this reduction fell within the error range of SmartNav for IS (+/−0.48 mm/s). No correlation was found between IS and the NRT ratio (p = 0.51), pure-tone audiometry (PTA) at CI activation (p = 0.506), and PTA (p = 0.94) or word recognition score (p = 0.231) at last evaluation. Conclusions: The estimated IS reported by SmartNav did not result in a clinically significant reduction in insertion speed or an improvement in CI hearing outcomes. Real-time feedback of IS could potentially be used for training, but its effectiveness requires confirmation through additional studies and more accurate tools. Implementation of IS assessment in clinical practice will enable comparisons between measurement techniques and between manual and robot-assisted insertions. This will help define the optimal IS range to achieve better cochlear implant (CI) outcomes.

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Section: Discussionmentioning

confidence: 99%