Feasibility of one-day activation in cochlear implant recipients

Hagr, Abdulrahman; Garadat, Soha N.; Al-momani, Murad O.; Alsabellha, Rabea M; Almuhawas, Fida

doi:10.3109/14992027.2014.996824

Cited by 37 publications

(42 citation statements)

References 27 publications

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“…In our previous study, we found a significant drop in impedance during initial mapping within 24 hours after cochlear implantation which may have been related to spontaneous recovery of the micro-environment inside the cochlea and a divergence effect of electrical stimulation after the device had been switched on [9]. Changes in impedance after early activation have also been reported in other studies [10, 11]. However, the detailed evolution of impedance after 1 day of activation has not previously been investigated.…”

Section: Introductionsupporting

confidence: 52%

“…Additional studies are required to investigate the detailed evolution of impedance after early activation with different implant systems [10, 30] to validate our results in devices with different designs. In addition, further studies are needed to investigate changes in maximum comfort and threshold levels [31] after early activation to better facilitate the mapping process in patients.…”

Section: Discussionmentioning

confidence: 98%

“…However, various studies investigating early activation have been published and shown the safety, feasibility and residual hearing preservation [9–12, 18, 19]. Early activation within 24 hours after surgery has been reported by our hospital [9, 12] and others [10]. A minimal access approach is critical to facilitate initial switch-on within 1 day, as this can help to minimize the degree of postoperative swelling [12].…”

Section: Discussionmentioning

confidence: 99%

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Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Chen

Tsai

et al. 2017

PLoS ONE

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ObjectivesChanges in impedance between 24 hours and one month after cochlear implantation have never been explored due to the inability to switch on within one day. This study examined the effect of early activation (within 24 hours) on the evolution of electrode impedance with the aim of providing information on the tissue-to-electrode interface when electrical stimulation was commenced one day post implantation.MethodsWe performed a retrospective review at a single institution. Patients who received a Nucleus 24RECA implant system (Cochlear, Sydney, Australia) and underwent initial switch-on within 24 hours postoperatively were included. Impedance measurements were obtained intraoperatively and postoperatively at 1 day, 1 week, 4 weeks, and 8 weeks.ResultsA significant drop in impedance was noted 1 day after an initial activation within 24 hours followed by a significant rise in impedance in all channels until 1 week, after which the impedance behaved differently in different segments. Basal and mid-portion electrodes revealed a slight increase while apical electrodes showed a slight decrease in impedance from 1 week to 8 weeks postoperatively. Impedance was relatively stable 4 weeks after surgery.ConclusionsThis is the first study to report the evolution of impedance in all channels between initial mapping 1 day and 1 month after cochlear implantation. The underlying mechanism for the differences in behavior between different segments of the electrode may be associated with the combined effect of dynamics among the interplay of cell cover formation, electrical stimulation, and fibrotic reaction.

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Section: Introductionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Chen

Tsai

et al. 2017

PLoS ONE

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“… 1 , 2 It has been further suggested that minimal access surgery may reduce soft tissue complications such as skin flap necrosis and scarring, 3 – 6 which may allow earlier device activation. 7 …”

mentioning

confidence: 99%

The use of an illuminated retractor in cochlear implantation: a comparative retrospective study

Alrashidi

Almuhawas

Hagr

et al. 2017

Annals of Saudi Medicine

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BACKGROUNDMinimal access surgery has been promoted to reduce the surgical duration and complications of cochlear implant (CI) surgery. A requirement of minimal access surgery is adequate visualization of the surgical cavities.OBJECTIVEThe aim of this study was to evaluate whether a new light-integrated surgical retractor reduced CI surgical time.DESIGNA retrospective comparative study.SETTINGTertiary referral otolaryngology clinic.PATIENTS AND METHODSWe reviewed the records of all patients who received implants between January 2013 to May 2014 at King Abdul-Aziz University Hospital before and after use of the illuminated retractor.MAIN OUTCOME MEASURE(S)Duration of surgery before and after the use of the illuminated retractor.RESULTSThere were no statistically significant differences in the surgical duration of CI relating to use of the illuminated retractor in 117 patients. The mean (SD) surgery duration in the unilateral cases was 132.7 (45.5) minutes before and 125.32 (42.76) minutes after use of the illuminated retractor (P=.479). For the bilateral cases, the mean (SD) surgical time was 213.6 (45.7) minutes before and 206.5 (45.5) minutes after use of the retractor (P=.702). There were no adverse events with use of the new tool.CONCLUSIONThe similar duration and lack of adverse events suggest that the illuminated retractor is safe to use when drilling the bony recess for the receiver-stimulator package within the subperiosteal pocket.LIMITATIONSThe method used to calculate surgical duration may explain why no reduction in duration was shown.

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“…Time spent in the deprived state may play a key role in solving this apparent contradiction (Giraud and Lee, 2007 ; Lee et al, 2007 ). How soon is too soon for surgical implantation and activation to maximize the risk-benefit trade off is debated and highly depends on individual factors (James and Papsin, 2004 ; Colletti et al, 2012 ; Hagr et al, 2015 ).…”

mentioning

confidence: 99%