Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes

Jagt, Annerie M. A. van der; Briaire, Jeroen J.; Verbist, Berit M.; Frijns, Johan H. M.

doi:10.1159/000448581

Cited by 30 publications

(41 citation statements)

References 37 publications

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“…The decision to use the 12 months follow-up criterion is based on data of Holden et al (10) who showed that most CI recipients reach stable speech perception performance after 1 year CI experience. Ten studies that were excluded from this review (6,9,11,14,44,53,56,59,61,64) investigated speech perception within the first year. Four out of 10 studies (40%), reported a significant positive correlation between angular insertion depth and speech perception, compared with one out of seven of the included studies (14%).…”

Section: Discussionmentioning

confidence: 99%

Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant: A Systematic Review

Heutink¹,

Rijk²,

Verbist

et al. 2019

Otology &Amp; Neurotology

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Objective: By discussing the design, findings, strengths, and weaknesses of available studies investigating the influence of angular insertion depth on speech perception, we intend to summarize the current status of evidence; and using evidence based conclusions, possibly contribute to the determination of the optimal cochlear implant (CI) electrode position. Data Sources: Our search strategy yielded 10,877 papers. PubMed, Ovid EMBASE, Web of Science, and the Cochrane Library were searched up to June 1, 2018. Both keywords and free-text terms, related to patient population, predictive factor, and outcome measurements were used. There were no restrictions in languages or year of publication. Study Selection: Seven articles were included in this systematic review. Articles eligible for inclusion: (a) investigated cochlear implantation of any CI system in adults with post-lingual onset of deafness and normal cochlear anatomy; (b) investigated the relationship between angular insertion depth and speech perception; (c) measured angular insertion depth on imaging; and (d) measured speech perception at, or beyond 1-year post-activation. Data Extraction and Synthesis: In included studies; quality was judged low-to-moderate and risk of bias, evaluated using a Quality-in-Prognostic-Studies-tool (QUIPS), was high. Included studies were too heterogeneous to perform meta-analyses, therefore, effect estimates of the individual studies are presented. Six out of seven included studies found no effect of angular insertion depth on speech perception. Conclusion: All included studies are characterized by methodological flaws, and therefore, evidence-based conclusions regarding the influence of angular insertion depth cannot be drawn to date.

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Section: Discussionmentioning

confidence: 99%

Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant: A Systematic Review

Heutink¹,

Rijk²,

Verbist

et al. 2019

Otology &Amp; Neurotology

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“…In addition, the optimal distance between electric and acoustic stimulation for the best EAS speech reception performance and long-term preservation of residual hearing is still unknown, and several aspects have to be taken into account. Different studies found varying effects of electrode insertion on speech reception for electric stimulation, with some reporting better performance with deeper insertion ( Hochmair et al 2003 ; Hamzavi & Arnoldner 2006 ; Buchman et al 2014 ; Büchner et al 2017 ) but others reporting no effect of insertion depth ( van der Jagt et al 2016 ). At the same time, deeper insertion has been shown to adversely affect hearing preservation in the implanted ear ( O'Connell et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Interaction Between Electric and Acoustic Stimulation Influences Speech Perception in Ipsilateral EAS Users

et al. 2019

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Objectives: The aim of this study was to determine electric-acoustic masking in cochlear implant users with ipsilateral residual hearing and different electrode insertion depths and to investigate the influence on speech reception. The effects of different fitting strategies—meet, overlap, and a newly developed masking adjusted fitting (UNMASKfit)—on speech reception are compared. If electric-acoustic masking has a detrimental effect on speech reception, the individualized UNMASKfit map might be able to reduce masking and thereby enhance speech reception. Design: Fifteen experienced MED-EL Flex electrode recipients with ipsilateral residual hearing participated in a crosssover design study using three fitting strategies for 4 weeks each. The following strategies were compared: (1) a meet fitting, dividing the frequency range between electric and acoustic stimulation, (2) an overlap fitting, delivering part of the frequency range both acoustically and electrically, and (3) the UNMASKfit, reducing the electric stimulation according to the individual electric-on-acoustic masking strength. A psychoacoustic masking procedure was used to measure the changes in acoustic thresholds due to the presence of electric maskers. Speech reception was measured in noise with the Oldenburg Matrix Sentence test. Results: Behavioral thresholds of acoustic probe tones were significantly elevated in the presence of electric maskers. A maximum of masking was observed when the difference in location between the electric and acoustic stimulation was around one octave in place frequency. Speech reception scores and strength of masking showed a dependency on residual hearing, and speech reception was significantly reduced in the overlap fitting strategy. Electric- acoustic stimulation significantly improved speech reception over electric stimulation alone, with a tendency toward a larger benefit with the UNMASKfit map. In addition, masking was significantly inversely correlated to the speech reception performance difference between the overlap and the meet fitting. Conclusions: (1) This study confirmed the interaction between ipsilateral electric and acoustic stimulation in a psychoacoustic masking experiment. (2) The overlap fitting yielded poorer speech reception performance in stationary noise especially in subjects with strong masking. (3) The newly developed UNMASKfit strategy yielded similar speech reception thresholds with an enhanced acoustic benefit, while at the same time reducing the electric stimulation. This could be beneficial in the long-term if applied as a standard fitting, as hair cells are exposed to less possibly adverse electric stimulation. In this study, the UNMASKfit allowed the participants a better use of their natural hearing even after 1 month of adaptation. It might be feasible to transfer these results to the clinic, by fitting patients with the UNMASKfit upon their first fitting appointment, so that longer adapta...

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“…In focussed stimulation schemes, the active electrode delivers the intended current waveform and flanking electrode contacts, which carry the opposite polarity of current to close the circuit loop, serve as the return electrodes. One example is partial tripolar (TP) stimulation, which decreases the current spread, improves spatial selectivity, and improves spectral resolution and speech performance in many CI patients (Bierer 2007;Zhu et al 2012;Srinivasan et al 2013;Padilla and Landsberger 2016). A major challenge in the clinical applicability of these stimulation modes is power consumption.…”

Section: Introductionmentioning

confidence: 99%

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial

Jong

Briaire

Woude

et al. 2019

International Journal of Audiology

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Objective: This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speechprocessing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient r. A recent acute pilot study showed improved spectral-temporally modulated ripple test (SMRT) scores at low loudness levels, but battery life was reduced to 1.5-4 hours. Design: Within-subject comparisons were made for the clinical versus. DCF strategy after 5 weeks of athome usage. Speech intelligibility in noise, spectral ripple discrimination, temporal modulation detection, loudness growth, and subjective ratings were assessed. Study sample: Twenty HiRes90K (Advanced Bionics, Valencia, USA) cochlear implant (CI) users. Results: Average battery life was 9 hours with the newly implemented DCF compared to 13.4 hours with the clinical strategy. Compared with measurements made at the beginning of the study, SMRT-scores and speech intelligibility in noise were significantly improved with DCF. However, both measures suffered from unexpected learning effects over time. The improvement disappeared and speech intelligibility in noise declined significantly relative to the final control measurement with the clinical strategy. Conclusion: Most CI users can adapt to the DCF strategy in a take-home setting. Although DCF has the potential to improve performance on the SMRT test, learning effects complicate the interpretation of the current results.

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Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes

Cited by 30 publications

References 37 publications

Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant: A Systematic Review

Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant: A Systematic Review

Interaction Between Electric and Acoustic Stimulation Influences Speech Perception in Ipsilateral EAS Users

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial

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