Scalar position in cochlear implant surgery and outcome in residual hearing and the vestibular system

Nordfalk, Karl Fredrik; Rasmussen, Kjell; Hopp, Einar; Greisiger, Ralf; Jablonski, Greg Eigner

doi:10.3109/14992027.2013.854413

Cited by 28 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is important to note that some studies were performed by the same group (Nordfalk et al [19, 21], Krause et al [22–24], and Kluenter et al [6, 25]). The authors were contacted to verify whether these studies have an overlap.…”

Section: Discussionmentioning

confidence: 99%

“…preNumber. postBasta [12]20081626121818Coordes [13]20121701431717Ernst [30]20061264141818Katsiari [2]201310104162020Krause [24]201014168223030Louza [34]2014291211304141Melvin [5]20091271151916Nordfalk [21]201493571212Nordfalk [19]201525813203333Robard [11]201522129253434Todt [36]2008392328346262Wagner [17]2010221817232020Normal pre = number of individuals with normal test results before surgery. Abnormal Pre = number of individuals with abnormal test results before surgery.…”

Section: Appendixmentioning

confidence: 99%

See 1 more Smart Citation

Effect of cochlear implant surgery on vestibular function: Meta-analysis study

Ibrahim

Silva

Segal

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

View full text Add to dashboard Cite

ImportanceVestibular disorders have been reported following cochlear implant (CI) surgery, but the literature shows a wide discrepancy in the reported clinical impact. The aim of this meta-analysis is to quantify the effect of CI before and after surgery on the outcomes of vestibular tests, postural stability, and subjective perception of dizziness.ObjectiveTo evaluate the effects of CI surgery on vestibular function in adult patients (≥18 years) with sensorineural hearing loss who underwent unilateral or bilateral implantation.Data sourcesMEDLINE, PubMed, Web of Science and Cochrane Library from January 1, 1995, through July 12, 2016.Study selectionPublished studies of adult patients who received unilateral or bilateral CIs and whose vestibular function or postural stability was assessed before and after surgery.Data extractionFrom each study, test results before and after surgery were compared, for the following five tests: clinical head impulse test (HIT); bi-thermal caloric irrigation of the horizontal semicircular canal; vestibular evoked myogenic potential (VEMP); dizziness handicap inventory (DHI); and computerized dynamic posturography (CDP).ResultsTwenty-seven studies met all inclusion criteria. Most studies performed either bi-thermal caloric irrigation and/or VEMP, with fewer studies investigating changes in HIT, posturography or DHI. CI surgery significantly affected the results of caloric and VEMP testing. However, HIT results, posturography, and DHI, scores were not significantly affected after CI surgery.Conclusions and relevanceCI surgery has a significant negative effect on the results of caloric as well as VEMP tests. No significant effect of CI surgery was detected in HIT, posturography, or DHI scores. Overall, the clinical effect of CI surgery on the vestibular function was found to be insignificant. Nonetheless, the potential effects of surgery on the vestibular system should be discussed with CI candidates before surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Appendixmentioning

confidence: 99%

Effect of cochlear implant surgery on vestibular function: Meta-analysis study

Ibrahim

Silva

Segal

et al. 2017

Journal of Otolaryngology - Head & Neck Surgery

View full text Add to dashboard Cite

show abstract

“…In contrast, all seven patients with scala vestibuli insertions lost hearing; this difference was statistically significant. Other authors have also noted loss of residual hearing in patients with electrode translocation, but small cohorts limited the ability to perform robust statistical comparisons . Taken together, it appears that scalar excursion is a strong predictor for loss of residual hearing.…”

Section: Introductionmentioning

confidence: 98%

The importance of electrode location in cochlear implantation

O’Connell

Hunter

Wanna

2016

Laryngoscope Investig Oto

115

View full text Add to dashboard Cite

ObjectivesAs indications for cochlear implantation have expanded to include patients with more residual hearing, increasing emphasis has been placed on minimally traumatic electrode insertion. Histopathologic evaluation remains the gold standard for evaluation of cochlear trauma, but advances in imaging techniques have allowed clinicians to determine scalar electrode location in vivo. This review will examine the relationship between scalar location of electrode arrays and audiologic outcomes. In addition, the impact that surgical approach, electrode design, and insertion depth have on scalar location will be evaluated. Data Sources: PubMed literature review Review Methods: A review of the current literature was conducted to analyze the relationship between scalar location of cochlear implant electrode arrays and speech perception outcomes. Further, data were reviewed to determine the impact that surgical variables have on scalar electrode location.ResultsElectrode insertions into the scala tympani are associated with superior speech perception and higher rates of hearing preservation. Lateral wall electrodes, and round window/extended round window approaches appear to maximize the likelihood of a scala tympani insertion. It does not appear that deeper insertions are associated with higher rates of scalar translocation.ConclusionSuperior audiologic outcomes are observed for electrode arrays inserted entirely within the scala tympani. The majority of clinical data demonstrate that lateral wall design and a round window approach increase the likelihood of a scala tympani insertion.Level of EvidenceN/A.

show abstract

“…Perhaps more important than the reduction of cochlear trauma associated with ST insertion, recent studies suggest that postoperative audiometric performance is better when all electrodes are positioned within the ST. 2, 4–6 Maintenance of residual hearing has also been shown to be superior in patients with electrodes positioned entirely within the ST. 7, 8 …”

Section: Introductionmentioning

confidence: 99%

Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation

O’Connell

Çakır

Hunter³

et al. 2016

Otology &Amp; Neurotology

213

261

View full text Add to dashboard Cite

Objectives-1) Investigate the impact of electrode type and surgical approach on scalar electrode location in a large patient cohort; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting-Tertiary academic hospital. Patients-220 post-lingually deafened adults undergoing cochlear implant (CI).Main Outcome Measures-Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance.Results-In 68% of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar(PM) and Mid-scala(MS) electrodes were p<0.001) times more likely to have at least one electrode in the scala vestibuli (SV) compared to lateral wall(LW) electrodes, respectively. Compared to cochleostomy(C), round window(RW) and extended round window(ERW) approaches demonstrated 70% reduction in SV insertion (OR 0.28,95%CI:0.1-0.8, p=0.01; ERW (OR O.28,95%CI:0.1-0.7, p=0.005). Examining postoperative audiometric performance, CNC score increased 0.6% with every 10° increase in angular insertion depth beyond the group minimum of 208° (Coefficient 0.0006,95%CI:0.0001-0.001, p=0.03). SV insertion was associated with a 12% decrease in CNC score (Coefficient -0.12,95%CI:-0.22--0.02, p=0.02). CNC score decreased 0.3% for every 1 year increase in age (Coefficient -0.003,95%CI:-0.006--0.0006), p=0.02). HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusions-Electrode design and surgical approach were predictors of scalar electrode location. Specifically, LW electrodes showed higher rates of ST insertion compared to PM or MS. RW and ERW approaches showed higher rates of ST insertion when compared to C. In regards to performance, ST insertion, younger age, and greater angular insertion depth were predictors of improved CNC scores.

show abstract

Scalar position in cochlear implant surgery and outcome in residual hearing and the vestibular system

Abstract: Our findings indicate that intracochlear electrode dislocation is a possible cause to loss of residual hearing during cochlear implantation but cannot be the sole cause of postoperative vestibular loss.

Cited by 28 publications

References 19 publications

Effect of cochlear implant surgery on vestibular function: Meta-analysis study

Effect of cochlear implant surgery on vestibular function: Meta-analysis study

The importance of electrode location in cochlear implantation

Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation

Contact Info

Product

Resources

About