Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array

McJunkin, Jonathan; Durakovic, Nedim; Herzog, Jacques A.; Buchman, Craig A.

doi:10.1097/mao.0000000000001652

Cited by 56 publications

(80 citation statements)

References 20 publications

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“…Due its reduced size, it can be inserted through the round window, which has been shown to be beneficial for ensuring initial scala tympani placement and results in better hearing preservation and improved speech perception scores [2,10,20]. Previously reported gains in postoperative speech perception and quality of life measures with the Nucleus CI532 are in line with those reported for other devices and are potentially better than with earlier Cochlear devices [3,10,23].…”

Section: Introductionmentioning

confidence: 72%

“…Previous studies using the Slim Modiolar electrode array showed consistent perimodiolar placement and scala tympani insertions in at least 87% of the patients assessed with imaging [1][2][3]. They reported hearing preservation is better than with older perimodiolar and straight designs, but possibly not as good as hybrid or electroacoustic devices that are specifically designed for hearing preservation [2,3,[9][10][11].…”

Section: Introductionmentioning

confidence: 94%

“…The Cochlear™ Slim Modiolar Electrode (CI532) is a perimodiolar array which was designed to be inserted with minimal damage to the cochlea and to bring the electrode contacts, which deliver the current to the nerve and spiral ganglion cells, closer to the modiolus [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…A growing body of evidence suggests that patients with the electrode array positioned in the scala tympani have the best speech perception outcomes, and outcomes are poorer in patients where the array has dislocated through the basilar membrane and some or all of the electrode contacts reside within the scala vestibuli [2,4,8]. Previous studies using the Slim Modiolar electrode array showed consistent perimodiolar placement and scala tympani insertions in at least 87% of the patients assessed with imaging [1][2][3]. They reported hearing preservation is better than with older perimodiolar and straight designs, but possibly not as good as hybrid or electroacoustic devices that are specifically designed for hearing preservation [2,3,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes for a clinically representative cohort of hearing-impaired adults using the Nucleus® CI532 cochlear implant

Hey¹,

Neben²,

Stöver

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Hearing performance data was collected from a large heterogeneous group of subjects implanted with the Coch-lear™ Nucleus® CI532 with Slim Modiolar Electrode, for the purposes of postmarket clinical follow-up. Data was analysed for factors which may predict postoperative speech recognition scores. Methods Data was collected retrospectively from five German clinics for 159 subjects from March 2017 to August 2018. Hearing thresholds and recognition scores for monosyllabic words in quiet and sentences in noise were measured preoperatively and at 3 and 6 months postoperatively. Results There was a mean gain of 44% points (95% CI 39-49%) at 6 months in monosyllable scores in quiet for implanted ears. Preoperative hearing thresholds in implant ears increased systematically with decreasing age; however, younger subjects had better baseline monosyllable scores with hearing aids compared with older subjects. Baseline performance alone explained 14% of the variation in postoperative scores. Residual hearing was preserved on average to within 22 dB at 250 Hz and 30 dB at 500 Hz of preoperative levels. Conclusions In a large and varied cohort of routinely treated hearing-impaired adults, speech recognition with the CI532 for German monosyllabic words in quiet at 6 months was equivalent to performance reported at one year or more in other published studies. Although younger subjects had poorer preoperative pure-tone thresholds, they had better preoperative word recognition scores compared with older subjects, and also had higher post implant scores. Further research is required to identify if this phenomenon is just applicable to German health system assessment and referral practices.

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Section: Introductionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes for a clinically representative cohort of hearing-impaired adults using the Nucleus® CI532 cochlear implant

Hey¹,

Neben²,

Stöver

et al. 2020

Eur Arch Otorhinolaryngol

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“…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 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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Detection of Tip Fold‐Over of the Slim Modiolar Electrode Using Intraoperative Mobile Cone‐Beam Computed Tomography

Inoue

Tona

Okano

et al. 2023

Otolaryngol.--head neck surg.

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Objective. This study aimed to evaluate the importance of mobile cone-beam computed tomography in detecting tip fold-over of a slim modiolar electrode within the cochlea during surgery.Study Design. Retrospective case review.Setting. Tertiary medical center.Methods. From January 2020 to June 2022, 33 ears of 30 patients with normal cochlear morphology underwent cochlear implantation with slim modiolar electrodes and intraoperative mobile cone-beam computed tomography imaging. Furthermore, we retrospectively reviewed the medical records and images.Results. The tip fold-over of the electrodes was detected using mobile cone-beam computed tomography in 3 out of 33 ears (9.1%). We could not identify the tip fold-over by scouting plain X-ray images in 2 out of 3 cases before taking the cone-beam computed tomography images. Electrode removal and reinsertion were performed before wound closure and the successful reinsertion was confirmed by mobile cone-beam computed tomography. The folded electrode tips were located at 238.8°, 152°, and 185.8°. Conclusion.Intraoperative mobile cone-beam computed tomography is useful in detecting the tip fold-over of the slim modiolar electrodes during surgery. Therefore, it was possible to reinsert the electrodes in all cases before closing the wound, eliminating the need for revision surgeries. Moreover, the analysis of mobile cone-beam computed tomography images may help to elucidate the mechanisms of electrode tip fold-over.

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Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array

Abstract: CI532 array insertion results in consistent scala tympani location and provides expected audiologic performance. Initial hearing preservation results are not consistent with current electro-acoustic arrays.

Cited by 56 publications

References 20 publications

Outcomes for a clinically representative cohort of hearing-impaired adults using the Nucleus® CI532 cochlear implant

Outcomes for a clinically representative cohort of hearing-impaired adults using the Nucleus® CI532 cochlear implant

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

Detection of Tip Fold‐Over of the Slim Modiolar Electrode Using Intraoperative Mobile Cone‐Beam Computed Tomography

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