<scp>Long‐Term</scp> Influence of Electrode Array Length on Speech Recognition in Cochlear Implant Users

Canfarotta, Michael W; Dillon, Margaret T.; Buchman, Craig A.; Buss, Emily; O’Connell, Brendan P.; Rooth, Meredith A; King, English R.; Pillsbury, Harold C.; Adunka, Oliver F.; Brown, Kevin D.

doi:10.1002/lary.28949

Cited by 30 publications

(37 citation statements)

References 45 publications

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“…HRCT and magnetic resonance imaging had been conducted preoperatively and patients with cochlear anomalies and signs of sclerosis or obliteration were excluded from this study. We only included patients inserted with a Cochlear™ Contour Advance ® (CI24RECA, CI412/512/612) (= CA), Cochlear™ slim straight ® (422/522/622) (= SSA) or Cochlear™ slim modiolar ® (532/632) electrode array (= SMA) (Cochlear Limited, NSW, Sydney, Australia) and MED-EL Flex 24 , MED-EL Flex 28 and MED-EL Flex Soft (MED-EL, Innsbruck, Austria). Electrode arrays were inserted via cochleostomy (= CS), round window (= RW) and extended round window (= ERW) insertion.…”

Section: Study and Subjectmentioning

confidence: 99%

“…The patient chose the manufacturer following individual consulting. If the patient chose MED EL and showed residual hearing, the FLEX 24 was used in most cases. In patients implanted with a device from Cochlear™, the SSA or the SMA was used in patients with residual hearing, otherwise the CA was also used quite often due to the later availability of the SSA and the SMA.…”

Section: Study and Subjectmentioning

confidence: 99%

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Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

Ketterer

Aschendorff

Arndt

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose The aim of this study is to examine the scalar dislocation rate in straight and perimodiolar electrode arrays in relation to cochlear morphology. Furthermore, we aim to analyze the specific dislocation point of electrode arrays depending on their design and shape and to correlate these results to postoperative speech perception. Methods We conducted a comparative analysis of patients (ears: n = 495) implanted between 2013 and 2018 with inserted perimodiolar or straight electrode arrays from Cochlear™ or MED-EL. CBCT (cone beam computed tomography) was used to determine electrode array position (scalar insertion, intra-cochlear dislocation, point of dislocation and angular insertion depth). Furthermore, cochlear morphology was measured. The postoperative speech discrimination was compared regarding electrode array dislocation, primary scalar insertion and angular insertion depth. Results The electrode array with the highest rate of primary SV insertions was the CA; the electrode array with the highest rate of dislocations out of ST was the FlexSoft. We did not find significantly higher dislocation rates in cochleostomy-inserted arrays. The angle of dislocation was electrode array design-specific. A multivariate nonparametric analysis revealed that the dislocation of the electrode array has no significant influence on postoperative speech perception. Nevertheless, increasing angular insertion depth significantly reduced postoperative speech perception for monosyllables. Conclusion This study demonstrates the significant influence of electrode array design on scalar location, dislocation and the angle of dislocation itself. Straight and perimodiolar electrode arrays differ from each other regarding both the rate and place of dislocation. Insertion via cochleostomy does not lead to increased dislocation rates in any of the included electrode arrays. Furthermore, speech perception is significantly negatively influenced by angular insertion depth.

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Section: Study and Subjectmentioning

confidence: 99%

Section: Study and Subjectmentioning

confidence: 99%

Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

Ketterer

Aschendorff

Arndt

et al. 2021

Eur Arch Otorhinolaryngol

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“…As the group around Canfarotta reported, patients with CI alone and longer electrodes seem to have a lower degree of frequency-to-place mismatch than patients with residual hearing and electric acoustic stimulation [24]. In addition, they found a better long-term speech recognition in patients with a 31.5 mm electrode, than those with a 24 mm array [46]. At the same time, the same research group observed a greater likelihood of preservation of the lower frequencies in patients with longer CDL (up to 36.5 mm) with the same electrode (31.5 mm) [47].…”

Section: Discussionmentioning

confidence: 89%

Variation of the cochlear anatomy and cochlea duct length: analysis with a new tablet-based software

Spiegel

Polterauer

Hempel

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose In cochlear implantation, thorough preoperative planning together with measurement of the cochlear duct length (CDL) assists in choosing the correct electrode length. For measuring the CDL, different techniques have been introduced in the past century along with the then available technology. A tablet-based software offers an easy and intuitive way to visualize and analyze the anatomy of the temporal bone, its proportions and measure the CDL. Therefore, we investigated the calculation technique of the CDL via a tablet-based software on our own cohort retrospectively. Methods One hundred and eight preoperative computed tomography scans of the temporal bone (slice thickness < 0.7 mm) of already implanted FLEX28™ and FLEXSOFT™ patients were found eligible for analysis with the OTOPLAN software. Measurements were performed by two trained investigators independently. CDL, angular insertion depth (AID), and cochlear coverage were calculated and compared between groups of electrode types, sex, sides, and age. Results Mean CDL was 36.2 ± 1.8 mm with significant differences between sex (female: 35.8 ± 0.3 mm; male: 36.5 ± 0.2 mm; p = 0.037), but none concerning side or age. Differences in mean AID (FLEX28: 525.4 ± 46.4°; FLEXSOFT: 615.4 ± 47.6°), and cochlear coverage (FLEX28: 63.9 ± 5.6%; FLEXSOFT: 75.8 ± 4.3%) were significant (p < 0.001). Conclusion A broad range of CDL was observed with significant larger values in male, but no significant differences concerning side or age. Almost every cochlea was measured longer than 31.0 mm. Preoperative assessment aids in prevention of complications (incomplete insertion, kinking, tipfoldover), attempt of atraumatic insertion, and addressing individual necessities (hearing preservation, cochlear malformation). The preferred AID of 720° (two turns of the cochlea) was never reached, opening the discussion for the requirement of longer CI-electrodes versus a debatable audiological benefit for the patient in his/her everyday life.

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“…The insertion of the dummy insertion electrode to a length of 30 mm inside the SV convinced us to choose a 28 mm long electrode and flexible array. Also, for the reason that this patient was profoundly deaf across all frequencies tested preoperatively, electrical stimulation across the entire frequency range was thought to be necessary and as supported by recent reports [22][23][24].…”

Section: Discussionmentioning

confidence: 80%

Scala vestibuli cochlear implant supported by 3D modeling of the inner ear

Holzmeister

Andrianakis

Kiss

et al. 2021

Wien Klin Wochenschr

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SummaryPatients with scala tympani (ST) ossification present a distinct surgical challenge. Three-dimensional (3D) segmentation of the inner ear offers accurate identification of ossification and surgical planning of the cochleostomy to access the scala vestibuli. The scala vestibuli placement of cochlear implantation electrode is an alternate solution in these patients and is well supported by the literature.The present report describes a case of cochlear implantation in the scala vestibuli assisted by 3D segmentation of the cochlea for a patient with ossification in the ST and reviews the relevant literature. Clinical presentation of a 45-year-old Austrian female who was referred with a history of sudden sensorineural hearing loss 2 years ago in the right ear, confirmed by pure tone audiometry (PTA) and acoustically evoked auditory brainstem response (ABR). 3D segmentation of the inner ear identified the extent of ossification in the ST and assisted in the surgical planning of cochleostomy drilling anterior-superior to the round window to access the scala vestibuli for the electrode placement. Postoperative computed tomography (CT) to confirm the electrode placement in the scala vestibuli and PTA was performed to assess the hearing threshold following the cochlear implantation. Postoperative CT confirmed the full insertion of a flexible electrode. The hearing threshold measured by PTA was ≤ 40 dB across all frequencies tested. Review of the literature identified a total of 13 published reports on cochlear implantation electrode placement in scala vestibuli in cases with ossification in the ST.

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Long‐Term Influence of Electrode Array Length on Speech Recognition in Cochlear Implant Users

Cited by 30 publications

References 45 publications

Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

Variation of the cochlear anatomy and cochlea duct length: analysis with a new tablet-based software

Scala vestibuli cochlear implant supported by 3D modeling of the inner ear

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