Comparative Performance of Lateral Wall and Perimodiolar Cochlear Implant Arrays

Sturm, Joshua J.; Patel, Vir; Dibelius, Greg; Kuhlmey, Megan; Kim, Ana H.

doi:10.1097/mao.0000000000002997

Cited by 24 publications

(27 citation statements)

References 27 publications

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“…Screening by title and abstract excluded 1263 articles. Full‐text review of the remaining articles excluded 259 publications, resulting in 22 articles being included in the final analysis 29–50 . The search process is summarized in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta‐analysis

Fried

Nguyen

et al. 2022

The Laryngoscope

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Objectives To examine patterns of change and plateau in speech recognition scores in postlingually hearing impaired adult cochlear implant recipients. The study also examines variations in change patterns for different speech materials and testing conditions. Study Design Used systematic review with meta‐analysis. Methods Articles in English reporting speech recognition scores of adults with postlingual hearing loss at pre‐implantation and at least two post‐implantation time points were included. Statistically significant changes were determined by meta‐analysis and the 95% confidence interval. Results A total of 22 articles representing 1954 patients were included. Meta‐analysis of mean difference demonstrated significant improvements in speech recognition score for words in quiet (37.4%; 95% confidence interval [34.7%, 40.7%]), sentences in quiet (49.4%; 95% confidence interval [44.9%, 53.9%]), and sentences in noise (30.8%; 95% confidence interval [25.2%, 36.4%]) from pre‐op to 3 months. Scores continued to increase from 3 to 12 months but did not reach significance. Similarly, significant improvements from pre‐op to 3 months were observed for consonant nucleus consonant (CNC) words in quiet (37.1%; 95% confidence interval [33.8%, 40.4%]), hearing in noise test (HINT) sentences in quiet (46.5%; 95% confidence interval [37.0%, 56.0%]), AzBio sentences in quiet (45.9%; 95% confidence interval [44.2%, 47.5%]), and AzBio sentences in noise (26.4%; 95% confidence interval [18.6%, 34.2%]). HINT sentences in noise demonstrated improvement from pre‐op to 3 months (35.1%; 95% confidence interval [30.0%, 40.3%]) and from 3 to 12 months (15.5%; 95% confidence interval [7.2%, 23.8%]). Conclusions Mean speech recognition scores demonstrate significant improvement within the first 3 months, with no further statistically significant improvement after 3 months. However, large individual variation should be expected and future research is needed to explain the sources of these individual differences. Laryngoscope, 133:1014–1024, 2023

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Section: Resultsmentioning

confidence: 99%

Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta‐analysis

Fried

Nguyen

et al. 2022

The Laryngoscope

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“…The debate between PM versus LW electrode and performance advantage is longstanding and controversial (12,30,31). Studies have demonstrated LW electrodes may be associated with improved speech perception scores (12,23,30).…”

Section: Discussionmentioning

confidence: 99%

Long-term Hearing Preservation and Speech Perception Performance Outcomes With the Slim Modiolar Electrode

Shew

Walia

Durakovic

et al. 2021

Otology &Amp; Neurotology

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Objective: Describe audiologic outcomes in hearing preservation (HP) cochlear implant candidates using a slim modiolar electrode (SME). Study Design: Retrospective. Setting: Tertiary referral center. Patients: Two hundred three adult cochlear implant patients with preoperative low-frequency pure-tone average (LFPTA) 80 dB HL that received the SME. Intervention: Implantation with a SME electrode. Main Outcome Measures: Primary outcome was postoperative HP, defined as LFPTA 80 dB HL. HP status was analyzed at ''early'' (activation or 3 mo) and ''long-term'' (6 or 12 mo) time frames using the patient's worst audiogram. Speech perception tests were compared between HP and non-HP cohorts. Results: Of the 203 HP candidates, the tip fold-over rate was 7.4%. The mean shifts in LFPTA at the ''early'' and ''long-term'' time points were 25.9 AE 16.2 dB HL and 29.6 AE 16.9 dB HL, respectively. Of 117 patients with preoper-ative LFPTA 60 dB HL, the early and long-term mean LFPTA shifts were 19.5 AE 12.3 dB HL and 32.6 AE 17.2 dB HL, respectively; early and long-term HP rates were 61.1% and 50.8%, respectively. For patients with preoperative LFPTA 80 dB HL, early and long-term HP rates were 45.5% and 43.7%, respectively. No significant difference was observed in postoperative speech perception performance (CNC, AzBio, HINT) at 3, 6, or 12 months between HP versus non-HP groups. Conclusions: HP is feasible using the SME. While electroacoustic stimulation was not studied in this cohort, HP provided no clear advantage in speech perception abilities in this group of patients. The current reporting standard of what constitutes HP candidacy (preoperative LFPTA 80 dB HL) should be reconsidered.

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“…There is no clear consensus on the ideal electrode that can optimize both HP and performance in CI candidates with good residual low‐frequency hearing. Some major differences between SME and SLWE feature electrode length and cochlear coverage, angular insertion depths, distance to neural elements, the potential for cochlear trauma and trans‐scalar positioning, rates of tip rollover, and need for modified cochleostomies 11,15,16 . SLWE arrays are shorter and more flexible than precurved arrays and are thought to decrease the likelihood of transcalar positioning and increase the chances of HP 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Some major differences between SME and SLWE feature electrode length and cochlear coverage, angular insertion depths, distance to neural elements, the potential for cochlear trauma and trans-scalar positioning, rates of tip rollover, and need for modified cochleostomies. 11,15,16 SLWE arrays are shorter and more flexible than precurved arrays and are thought to decrease the likelihood of transcalar positioning and increase the chances of HP. 17 Comparatively, they have shallower angular insertion angles, as was demonstrated in our study.…”

Section: Sme Versus Slwe Design and Implicationsmentioning

confidence: 99%

One‐Year Hearing Preservation and Speech Outcomes Comparing Slim Modiolar and Lateral Wall Arrays

Zhan

Walia

Durakovic

et al. 2023

Otolaryngol.--head neck surg.

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Objective. Compare postoperative speech outcomes in hearing preservation (HP) cochlear implantation (CI) patients with a low-frequency pure-tone average (LFPTA) ≤ 60 dB using 2 electrode array designs.Study Design. Retrospective cohort study.Setting. Large academic cochlear implant referral center.Methods. We reviewed adult HP CI cases using either the slim modiolar electrode (SME) (CI 532/CI 632) or th slim lateral wall electrode (SLWE) (CI 624). One-year speech outcomes and HP status were the primary outcomes.Results. A total of 132 implanted ears were analyzed (mean age 73.1 years, standard deviation [SD] 12.6), with 72% (N = 95) with CI 532/632 and 28% (N = 37) with CI 624. The mean preoperative LFPTA was 44.8 dB, SD 11.8. One-year functional HP was 27.2% (mean LFPTA shift 46.1 dB, SD 22.1) and was as follows: SME 23.9% and SLWE 36.4%, p = .168. The mean age at implantation was significantly younger only in SLWE patients with preserved hearing (66.9 vs 80.3 years, p = .008). At 6 months, speech measures were significantly better in all outcomes in HP patients with an SLWE than nonpreserved SLWE patients; this effect abated at 1 year as performance among nonpreserved SLWE patients became equivalent to the remaining cohort. Speech outcomes in SME patients were similar regardless of HP status. Age at implantation and datalogging was correlated with speech outcomes. Conclusion.In this cohort of HP patients, a 1-year functional HP rate of 23.9% (SME) and 36.4% (SLWE) was observed (p = 0.168). This was initially 57.1% (SME) and 70.3% (SLWE) at activation, p = .172. Datalogging and age at implantation were correlated with postoperative speech outcomes.

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Comparative Performance of Lateral Wall and Perimodiolar Cochlear Implant Arrays

Cited by 24 publications

References 27 publications

Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta‐analysis

Longitudinal Speech Recognition Changes After Cochlear Implant: Systematic Review and Meta‐analysis

Long-term Hearing Preservation and Speech Perception Performance Outcomes With the Slim Modiolar Electrode

One‐Year Hearing Preservation and Speech Outcomes Comparing Slim Modiolar and Lateral Wall Arrays

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