Clinical Evaluation of the Clarion CII HiFocus 1 with and Without Positioner

Beek, Feddo B. van der; Boermans, Peter Paul B M; Verbist, Berit M.; Briaire, Jeroen J.; Frijns, Johan H. M.

doi:10.1097/01.aud.0000188116.30954.21

Cited by 42 publications

(47 citation statements)

References 43 publications

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“…Electrode field potential can be obtained by stimulating one electrode while recording the potential in other non-stimulating electrodes. Electrical field imaging plots the potential distribution as a function of electrode position and can be a useful clinical tool to probe the interference and interaction between electrodes [108].…”

Section: Back Telemetrymentioning

confidence: 99%

Cochlear Implants: System Design, Integration, and Evaluation

Zeng

Rebscher

Harrison³

et al. 2008

IEEE Rev. Biomed. Eng.

655

198

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As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120,000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues from design and specifications to integration and evaluation. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants.

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Section: Back Telemetrymentioning

confidence: 99%

Cochlear Implants: System Design, Integration, and Evaluation

Zeng

Rebscher

Harrison³

et al. 2008

IEEE Rev. Biomed. Eng.

655

198

View full text Add to dashboard Cite

show abstract

“…Factors affecting this interface include the distance to the modiolus, the amount and density of excitable nerve fibers, the amount of fluid surrounding the electrode and the presence of scar tissue. Several studies have shown that the intracochlear electrode position is correlated with speech perception scores [Finley et al, 2008;Holden et al, 2013;van der Beek et al, 2005]. The relationship between the intracochlear electrode position and the outcomes of cochlear implantation appears to be a reflection of the efficacy of the transfer of the electrical stimulus to the nerve fibers.…”

Section: Introductionmentioning

confidence: 99%

Intracochlear Position of Cochlear Implants Determined Using CT Scanning versus Fitting Levels: Higher Threshold Levels at Basal Turn

Beek

Briaire²,

Marel³

et al. 2016

Audiol Neurotol

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Objectives: In this study, the effects of the intracochlear position of cochlear implants on the clinical fitting levels were analyzed. Design: A total of 130 adult subjects who used a CII/HiRes 90K cochlear implant with a HiFocus 1/1J electrode were included in the study. The insertion angle and the distance to the modiolus of each electrode contact were determined using high-resolution CT scanning. The threshold levels (T-levels) and maximum comfort levels (M-levels) at 1 year of follow-up were determined. The degree of speech perception of the subjects was evaluated during routine clinical follow-up. Results: The depths of insertion of all the electrode contacts were determined. The distance to the modiolus was significantly smaller at the basal and apical cochlear parts compared with that at the middle of the cochlea (p < 0.05). The T-levels increased toward the basal end of the cochlea (3.4 dB). Additionally, the M-levels, which were fitted in our clinic using a standard profile, also increased toward the basal end, although with a lower amplitude (1.3 dB). Accordingly, the dynamic range decreased toward the basal end (2.1 dB). No correlation was found between the distance to the modiolus and the T-level or the M-level. Furthermore, the correlation between the insertion depth and stimulation levels was not affected by the duration of deafness, age at implantation or the time since implantation. Additionally, the T-levels showed a significant correlation with the speech perception scores (p < 0.05). Conclusions: The stimulation levels of the cochlear implants were affected by the intracochlear position of the electrode contacts, which were determined using postoperative CT scanning. Interestingly, these levels depended on the insertion depth, whereas the distance to the modiolus did not affect the stimulation levels. The T-levels increased toward the basal end of the cochlea. The level profiles were independent of the overall stimulation levels and were not affected by the biographical data of the patients, such as the duration of deafness, age at implantation or time since implantation. Further research is required to elucidate how fitting using level profiles with an increase toward the basal end of the cochlea benefits speech perception. Future investigations may elucidate an explanation for the effects of the intracochlear electrode position on the stimulation levels and might facilitate future improvements in electrode design.

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“…Close proximity to the modiolus has been shown to lower M levels or C levels (depending on the brand) and electrically evoked compound action potential thresholds, which facilitate more focused stimulation and optimization of pulse width [Dorman et al, 2007;Filipo et al, 2008;van der Beek et al, 2005;van Wermeskerken et al, 2009]. According to Briggs et al [2001], proximity to the modiolus can be achieved without intracochlear damage, provided a free-fitting electrode array of appropriate size and shape is used and inserted in the scala tympani.…”

Section: Introductionmentioning

confidence: 99%

“…The relation between electrode position and speech perception is an often studied one [Aschendorff et al, 2007;Baskent and Shannon, 2005;Finley et al, 2008;Skinner et al, 2007;van der Beek et al, 2005;Yukawa et al, 2004]. Frequency alignment, the prevention of intracochlear trauma and the preservation of residual hearing are important topics related to this matter.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Cochlear Implant Electrode Position on Performance

Marel¹,

Briaire²,

Verbist

et al. 2015

Audiol Neurotol

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Objectives: To study the relation between variables related to cochlear implant electrode position and speech perception performance scores in a large patient population. Design: The study sample consisted of 203 patients implanted with a CII or HiRes90K implant with a HiFocus 1 or 1J electrode of Advanced Bionics. Phoneme and word score averages for the 1- and 2-year follow-up were calculated for 41 prelingually deaf and 162 postlingually deaf patients. Analyses to reveal correlations between these performance outcomes and 6 position-related variables (angle of most basal electrode contact, surgical insertion angle, surgical insertion, wrapping factor, angular insertion depth, linear insertion depth) were executed. The scalar location, as an indication for the presence of intracochlear trauma, and modiolus proximity beyond the basal turn were not evaluated in this study. In addition, different patient-specific variables (age at implantation, age at onset of hearing loss, duration of deafness, preoperative phoneme and word scores) were tested for correlation with performance. Results: The performance scores of prelingual patients were correlated with age at onset of hearing loss, duration of deafness and preoperative scores. For the postlingual patients, performance showed correlations with all 5 patient-specific variables. None of the 6 position-related variables influenced speech perception in cochlear implant patients. Conclusions: Although several patient-specific variables showed correlations with speech perception outcomes, not one of the studied angular and linear position-related variables turned out to have a demonstrable influence on performance.

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Clinical Evaluation of the Clarion CII HiFocus 1 with and Without Positioner

Cited by 42 publications

References 43 publications

Cochlear Implants: System Design, Integration, and Evaluation

Cochlear Implants: System Design, Integration, and Evaluation

Intracochlear Position of Cochlear Implants Determined Using CT Scanning versus Fitting Levels: Higher Threshold Levels at Basal Turn

The Influence of Cochlear Implant Electrode Position on Performance

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