Hearing Preservation with the Slim Modiolar Electrode Nucleus CI532® Cochlear Implant: A Preliminary Experience

Ramos‐Macías, Ángel; Barreiro, Silvia Borkoski; Falcón-González, Juan Carlos; Miguel, Angel R. De

doi:10.1159/000486409

Cited by 38 publications

(32 citation statements)

References 20 publications

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“…We chose to present our data according to the most common definitions used in the literature. The hearing preservation rates achieved with the SME appear to be superior to other stylet-type PMEs [21,42,43]. The majority of patients (72%) were initially fitted with an EAS strategy and 44% experienced benefits with the acoustic stimulation and continued to use the device.…”

Section: Discussionmentioning

confidence: 89%

Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

Iso-Mustajärvi

Sipari

Löppönen

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing. Methods We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA (0.125-0.5 kHz) ≤ 80 dB HL). The insertion results were reexamined from the postoperative cone-beam computed tomography scans. Postoperative thresholds were obtained at the time of switch-on of the sound processors (mean 43 days) and at latest follow-up (mean 582 days). The speech recognition in noise was measured with the Finnish matrix sentence test preoperatively and at follow-up. Results The mean insertion depth angle (IDA) was 395°. Neither scala dislocations nor tip fold over were detected. There were no total hearing losses. Functional low-frequency hearing was preserved in 15/18 (83%) ears at switch-on and in 14/17 (82%) ears at follow-up. According to HEARRING classification, 55% (10/18) had complete HP at switch-on and 41% (7/17) still at follow-up. Thirteen patients (14 ears) were initially fitted with electric-acoustic stimulation and seven patients (8 ears) continued to use it after follow-up. Conclusions The preliminary hearing preservation results with the SME were more favorable than reported for other perimodiolar electrodes. The results show that the array may also be feasible for electro-acoustic stimulation; it is beneficial in that it provides adequate cochlear coverage for pure electrical stimulation in the event of postoperative or progressive hearing loss.

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Section: Discussionmentioning

confidence: 89%

Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

Iso-Mustajärvi

Sipari

Löppönen

et al. 2019

Eur Arch Otorhinolaryngol

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“…In 63.6% of the participants without a tip fold-over (n = 22), all electrode contacts were placed inside the ST, whereas 36.4% showed a translocation from the ST to the SV. In comparison, Shaul et al [11], Aschendorff et al [12] and Ramos et al [16] found that 100% of in total 73 participants had full ST placement of the SPE; a CS approach was used in 15 participants, and the eRW or RW approach in 58 participants. While evaluating scalar location in 23/117 participants, McJunkin et al [15] found 73.9% to have full ST insertion all implanted using the eRW approach.…”

Section: Scalar Positionmentioning

confidence: 99%

“…It was observed that independent of the type of electrode used, full scala tympani (ST) position [8] and preservation of residual hearing [8,10] is more likely using a RW or eRW approach, compared to the CS approach. These findings might contribute to the fact that to-date, eRW and RW approaches were used in 91.8% (236/257) of the participants in the five studies that investigated the SPE [11,12,[14][15][16].…”

Section: Rationalementioning

confidence: 99%

“…The scalar position of the SPE, visualized in high-resolution imaging, was evaluated in 96 out of these 257 participants [11,12,15,16]. Out of these participants, 81 were implanted using the RW or eRW approach [11,12,15,16]; in 6 participants, a translocation had occurred [15]. In the remaining, relatively low number of 15 patients in whom the CS approach was used, no translocation was observed [12].…”

Section: Rationalementioning

confidence: 99%

“…Characteristics of participants a Participant numbers 1, 2, 4, 5, 6, 9, 10, 13, 18, 20, 22 and 23 were defined as having late onset of hearing loss and participants numbers3,7,8,11,12,14,15,16,17,19 and 21 were defined as…”

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confidence: 99%

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The evaluation of a slim perimodiolar electrode: surgical technique in relation to intracochlear position and cochlear implant outcomes

Heutink

Verbist

Mens

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose In cochlear implantation (CI), the two factors that are determined by the surgeon with a potential significant impact on the position of the electrode within the cochlea and the potential outcome, are the surgical technique and electrode type. The objective of this prospective study was to evaluate the position of the slim, perimodiolar electrode (SPE), and to study the influence of the SPE position on CI outcome. Methods Twenty-three consecutively implanted, adult SPE candidates were included in this prospective cohort study conducted between December 2016 and April 2019. Mean age at surgery was 59.5 years. Mean preoperative residual hearing was 92.2 dB. Intra-operative fluoroscopy and high-resolution computed tomography scans were performed to evaluate electrode position after insertion using a cochleostomy (CS) approach. Follow-up was 12 months after implantation; residual hearing (6-8 weeks) and speech perception (6-8 weeks and 12 months) were evaluated in relation to the intracochlear SPE position. Results In most patients in whom the SPE was positioned in the scala tympani residual hearing was preserved [mean absolute increase in PTA of 4.4 dB and 77.2% relative hearing preservation (RHP%)]. Translocation into the scala vestibuli occurred in 36% of the insertions, resulting in a mean absolute increase in PTA of 17.9 dB, and a RHP% of 19.2%. Participants with a translocation had poorer speech perception scores at 12-month follow-up. Conclusion Given the incidence of CS-associated translocations with the SPE and the negative effect on outcome, it is advised to insert the SPE using the (extended) round window approach.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss

Buchman

Gifford

Haynes

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCECochlear implants are a treatment option for individuals with severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss (SNHL) who receive little or no benefit from hearing aids; however, cochlear implantation in adults is still not routine.OBJECTIVE To develop consensus statements regarding the use of unilateral cochlear implants in adults with severe, profound, or moderate sloping to profound bilateral SNHL. DESIGN, SETTING, AND PARTICIPANTSThis study was a modified Delphi consensus process that was informed by a systematic review of the literature and clinical expertise. Searches were conducted in the following databases: (1) MEDLINE In-Process & Other Non-Indexed Citations and Ovid MEDLINE, (2) Embase, and (3) the Cochrane Library. Consensus statements on cochlear implantation were developed using the evidence identified. This consensus process was relevant for the use of unilateral cochlear implantation in adults with severe, profound, or moderate sloping to profound bilateral SNHL. The literature searches were conducted on July 18, 2018, and the 3-step Delphi consensus method took place over the subsequent 9-month period up to March 30, 2019. MAIN OUTCOMES AND MEASURESA Delphi consensus panel of 30 international specialists voted on consensus statements about cochlear implantation, informed by an SR of the literature and clinical expertise. This vote resulted in 20 evidence-based consensus statements that are in line with clinical experience. A modified 3-step Delphi consensus method was used to vote on and refine the consensus statements. This method consisted of 2 rounds of email questionnaires and a face-to-face meeting of panel members at the final round. All consensus statements were reviewed, discussed, and finalized at the face-to-face meeting. RESULTSIn total, 6492 articles were identified in the searches of the electronic databases. After removal of duplicate articles, 74 articles fulfilled all of the inclusion criteria and were used to create the 20 evidence-based consensus statements. These 20 consensus statements on the use of unilateral cochlear implantation in adults with SNHL were relevant to the following 7 key areas of interest: level of awareness of cochlear implantation (1 consensus statement); best practice clinical pathway from diagnosis to surgery (3 consensus statements); best practice guidelines for surgery (2 consensus statements); clinical effectiveness of cochlear implantation (4 consensus statements); factors associated with postimplantation outcomes (4 consensus statements); association between hearing loss and depression, cognition, and dementia (5 consensus statements); and cost implications of cochlear implantation (1 consensus statement).CONCLUSIONS AND RELEVANCE These consensus statements represent the first step toward the development of international guidelines on best practices for cochlear implantation in adults with SNHL. Further research to develop consensus statements for unilateral cochlear implantation in children, bilateral c...

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Hearing Preservation with the Slim Modiolar Electrode Nucleus CI532® Cochlear Implant: A Preliminary Experience

Cited by 38 publications

References 20 publications

Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode

The evaluation of a slim perimodiolar electrode: surgical technique in relation to intracochlear position and cochlear implant outcomes

Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss

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