Objective:
Evaluation of triphasic pulse stimulation in comparison to the traditional biphasic pulse stimulation in cochlear implant (CI) patients with unintended facial nerve costimulation.
Study Design:
Retrospective case review.
Setting:
Cochlear Implant Center of a University Department of Otolaryngology, Head and Neck Surgery.
Patients:
Fifteen CI patients (MED-EL, Innsbruck, Austria) received a triphasic fitting map instead of a biphasic fitting map due to a previous diagnosis of facial nerve stimulation or stimulus induced pain during the years 2014 to 2017.
Intervention(s):
Application of a triphasic stimulation strategy.
Main Outcome Measure(s):
Reduction of facial nerve costimulation and speech understanding. Biphasic and triphasic fitting maps were compared to accurately assess the effects of the switch, and hearing tests (monosyllables and sentences in noise tests) were analyzed.
Results:
Triphasic pulse stimulation showed a significant reduction of unintended side effects and resulted in an observed improved quality of life in most cases. Although there was no significant change in the understanding of speech with CI in all test situations, in many cases, improvement was observed.
Conclusions:
Triphasic pulse stimulation had a beneficial effect for CI patients with severe, unintended costimulation and should be considered a valuable tool during CI fitting.
SummaryThe Cologne-Diiren research group has developed a new extracochlear eight-channel electrode system. The first observations on six cases have shown encouraging psychoacoustic results.
The Cologne-Düren research group has developed a multichannel extracochlear method of implantation and has carried out 129 operations as of June 1985. To simulate the basic physiologic principles of the inner ear, we also used the place and periodicity principle. Experience so far has shown that the electrical stimulus pattern is perceived as an auditory sensation by the bony wall of the middle ear, and that even a certain selectivity can be achieved. All 129 patients have attained acoustic contact with the environment. They can largely differentiate environmental noises and distinguish human voices from each other. Their lipreading is substantially improved with the support of the speech processor. Moreover, pronunciation becomes very much more distinct in the congenitally deaf. Apart from these average results, signs of development of open speech were observed in 11% of the patients.
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