Effect of cochlear implant electrode array design on auditory nerve and behavioral response in children

Telmesani, Laila M.; Said, Nithreen M.

doi:10.1016/j.ijporl.2015.02.008

Cited by 28 publications

(22 citation statements)

References 24 publications

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“…Intra-operative ECAP thresholds were significantly lower for the apical electrodes than those at the base. This has been observed in many other studies (Gordin et al, 2009;Lathuilliere et al, 2017;Spivak et al, 2011;Telmesani and Said, 2015), and may be due to differences between the apex and base in neuronal survival or density (Lai and Dillier 2009;Polak et al 2004). There have been some suggestions that the radial distance between the modiolar wall and the electrode may also be a factor (Saunders et al, 2002;Spivak et al 2011).…”

Section: Discussionsupporting

confidence: 53%

“…The threshold of the evoked response represents the lowest current level required to stimulate cochlear neural elements and depends on many factors, including the scalar position of the stimulating electrodes. Some studies have shown that it can even be used as an indicator for translocation of the electrode array into the scala vestibuli, and electrode position within the scala tympani (ST), with lower ECAP thresholds in perimodiolar arrays compared with straight arrays (Mittman et al, 2015;Muller et al, 2015;Poley et al, 2015;Telmesani and Said, 2015;Venail et al, 2015). It is important that the electrode is inserted into the correct scala, as the insertion of the array into the ST without dislocation into the scala vestibuli has been associated with better speech perception outcomes (Aschendorff et al, 2007;Carlson et al, 2011;Finley et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Objective, audiological and quality of life measures with the CI532 slim modiolar electrode

Hey

Wesarg

Mewes

et al. 2018

Cochlear Implants International

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Objectives: To report on electrode array measurements for the Nucleus ® CI532 Slim Modiolar Electrode device including: ECAP thresholds, electrode impedances, and psychophysical comfort levels, as well as speech perception results pre-and post-operatively and standardized evaluations of quality of life. Methods: Forty-four subjects were implanted with the CI532. Electrically evoked compound action potential (ECAP) thresholds and impedances were measured using automatic Neural Response Telemetry intraoperatively, at activation and at six months post implant. Pre-and post-operative measures of words in quiet and sentences in noise were made in multiple languages. Quality of life was assessed using The Speech Spatial Qualities questionnaire (SSQ) and Glasgow Benefit Inventory (GBI). Results: Intra-operative ECAP thresholds were recorded successfully from 90% of electrodes tested. ECAP thresholds varied across the array and a post-hoc Dunn's test showed that median thresholds for electrodes E1-E13 were significantly greater than those for E17-E22 (all P < 0.001). Impedances increased significantly between surgery and activation. Speech recognition scores for words in quiet and sentences in noise showed a significant improvement for the group at six months, when using the cochlear implant, compared with pre-operative performance (P < 0.001). There was a significant increase compared to pre-operative ratings for all sections of the SSQ at six months post activation (P < 0.001). The GBI gave scores significantly above zero for the 'general' subscale and total score. Conclusion: Objective ECAP and impedance measures for this new electrode array were as expected and similar to results reported for other array types. Speech perception and quality of life improved significantly following implantation. (Registered as NCT02392403 on ClinicalTrials.gov PRS)

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Objective, audiological and quality of life measures with the CI532 slim modiolar electrode

Hey

Wesarg

Mewes

et al. 2018

Cochlear Implants International

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“…Several studies have demonstrated lower stimulation thresholds for permodiolar arrays than for straight arrays, either when measured psychophysically or when assessed by objective measures [Cohen et al, 2001;Gordin et al, 2009;Runge-Samuelson et al, 2009;Jeong et al, 2015;Müller et al, 2015;Telmesani and Said, 2015]. Other studies have reported a reduced spread of excitation using forward masking ECAP paradigms [Hughes and Abbas, 2006;Basta et al, 2010;Hughes and Stille, 2010] with improved spectral discrimination.…”

Section: Introductionmentioning

confidence: 99%

Clinical investigation of the Nucleus Slim Modiolar Electrode

et al. 2017

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Aims: The Nucleus CI532 cochlear implant incorporates a new precurved electrode array, i.e., the Slim Modiolar electrode (SME), which is designed to bring electrode contacts close to the medial wall of the cochlea while avoiding trauma due to scalar dislocation or contact with the lateral wall during insertion. The primary aim of this prospective study was to determine the final position of the electrode array in clinical cases as evaluated using flat-panel volume computed tomography. Methods: Forty-five adult candidates for unilateral cochlear implantation were recruited from 8 centers. Eleven surgeons attended a temporal bone workshop and received further training with a transparent plastic cochlear model just prior to the first surgery. Feedback on the surgical approach and use of the SME was collected via a questionnaire for each case. Computed tomography of the temporal bone was performed postoperatively using flat-panel digital volume tomography or cone beam systems. The primary measure was the final scalar position of the SME (completely in scala tympani or not). Secondly, medial-lateral position and insertion depth were evaluated. Results: Forty-four subjects received a CI532. The SME was located completely in scala tympani for all subjects. Pure round window (44% of the cases), extended round window (22%), and inferior and/or anterior cochleostomy (34%) approaches were successful across surgeons and cases. The SME was generally positioned close to the modiolus. Overinsertion of the array past the first marker tended to push the basal contacts towards the lateral wall and served only to increase the insertion depth of the first electrode contact without increasing the insertion depth of the most apical electrode. Complications were limited to tip fold-overs encountered in 2 subjects; both were attributed to surgical error, with both reimplanted successfully. Conclusions: The new Nucleus CI532 cochlear implant with SME achieved the design goal of producing little or no trauma as indicated by consistent scala tympani placement. Surgeons should be carefully trained to use the new deployment method such that tip fold-overs and over insertion may be avoided.

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“…The electrically evoked compound action potential (ECAP) has been widely used as a valuable objective tool in mapping the CI, especially for those who have difficulty in showing the reliable behavioral response [12]. Whereas some studies reported that the ECAP threshold, T level, and C level were lower for the PM than the LW, and were lower on the apical region than on the basal and medial regions [13-15], other studies showed different results [16,17]. These contrasting results may be because only a small number of subjects or subjects with much heterogeneity participated, only several electrode contacts were selected to represent the electrode site, and more recent LWs were included or exclude in the studies.…”

Section: Introductionmentioning

confidence: 99%

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types

et al. 2019

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Background and Objectives The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. Subjects and Methods Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. Results The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. Conclusions The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.

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Effect of cochlear implant electrode array design on auditory nerve and behavioral response in children

Cited by 28 publications

References 24 publications

Objective, audiological and quality of life measures with the CI532 slim modiolar electrode

Objective, audiological and quality of life measures with the CI532 slim modiolar electrode

Clinical investigation of the Nucleus Slim Modiolar Electrode

Effect of Cochlear Implant Electrode Array Design on Electrophysiological and Psychophysical Measures: Lateral Wall versus Perimodiolar Types

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