Effect of Electrode to Modiolus Distance on Electrophysiological and Psychophysical Parameters in CI Patients With Perimodiolar and Lateral Electrode Arrays

Degen, Chantal Vanessa; Büchner, Andreas; Kludt, E; Lenarz, Thomas

doi:10.1097/mao.0000000000002751

Cited by 15 publications

(17 citation statements)

References 15 publications

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“…3 a, b). However, this has been controversially discussed so far: whereas some groups observed NRT levels to be larger with increased distance to the modiolus [ 29 , 30 ], previous observations made by us and other groups revealed no significant differences [ 3 – 6 , 31 ].…”

Section: Discussionmentioning

confidence: 77%

Evaluation of hearing preservation in adults with a slim perimodiolar electrode

Riemann

Hans

Christov

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Numerous endeavors have been undertaken to preserve hearing in cochlear implant (CI) patients. Particularly, optimization of electrode array design aims at preservation of residual hearing (RH). This study examines whether a slim perimodiolar (PM) electrode array could bear the capability to preserve hearing. Methods A total of 47 patients underwent cochlear implantation receiving the PM electrode. (i) Patients with pure tone audiogram (PTA) thresholds better than 85 dB and/or hearing loss for Freiburg speech test numbers less than 60 dB and more than 50% maximum monosyllabic understanding were assigned to the RH group (n = 17), while all others belonged to the noRH group (n = 30). (ii) Another group implanted with a slim straight, lateral wall (LW) electrode was recruited for comparison. Results We compared 17 RH–30 noRH patients all receiving the PM electrode. RH in PM recipients decreased faster than in LW recipients. No significant differences were observed between both (RH v/s noRH) groups in NRT thresholds, Freiburg speech test and A§E® phonemes. Analogous satisfaction levels were indicated through the questionnaires in terms of sound quality, hearing in silence, noise and directional hearing in both groups. Conclusions The results suggest that hearing preservation is influenced not only by electrode shape but various factors. This study opens an avenue for further investigations to elucidate and enumerate the causes for progressive hearing loss.

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Section: Discussionmentioning

confidence: 77%

Evaluation of hearing preservation in adults with a slim perimodiolar electrode

Riemann

Hans

Christov

et al. 2021

Eur Arch Otorhinolaryngol

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“…Clinical imaging outcomes of electrode array in use within the first cochlear turn show distances in the range 0.60–1.67 mm (for Cochlear 532/632 array 0.80 ± 0.10 mm and for 512 array 0.76 ± 0.07 mm; data from Ref. 62 ). Closer locations, and thus true “modiolar hugging electrodes”, particularly those aiming at implantations beyond 400°, require new surgical and technical approaches due to the changing diameter of the modiolus.…”

Section: Discussionmentioning

confidence: 99%

Variations in microanatomy of the human modiolus require individualized cochlear implantation

Pietsch

Schurzig

Salcher

et al. 2022

Sci Rep

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Cochlear variability is of key importance for the clinical use of cochlear implants, the most successful neuroprosthetic device that is surgically placed into the cochlear scala tympani. Despite extensive literature on human cochlear variability, few information is available on the variability of the modiolar wall. In the present study, we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies (CTs) and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Lateral wall measures correlated with modiolar wall measures significantly. ~ 49% of the variability had a common cause. Based on these data we developed a model of the modiolar wall variations and related the model to the design of cochlear implants aimed for perimodiolar locations. The data demonstrate that both the insertion limits relevant for lateral wall damage (approximate range of 4–9 mm) as well as the dimensions required for optimal perimodiolar placement of the electrode (the point of release from the straightener; approximate range of 2–5mm) are highly interindividually variable. The data demonstrate that tip fold-overs of preformed implants likely result from the morphology of the modiolus (with radius changing from base to apex), and that optimal cochlear implantation of perimodiolar arrays cannot be guaranteed without an individualized surgical technique.

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“…10). Clinical imaging outcomes of electrode array in use within the first cochlear turn show distances in the range 0.60 -1.67 mm (for Cochlear 532/632 array 0.80±0.10 mm and for array 0.76±0.07 mm; data from 58 ). Closer locations, and thus true "modiolar hugging electrodes", particularly those aiming at implantations beyond 400°, require new surgical and technical approaches due to the changing diameter of the modiolus.…”

Section: Discussionmentioning

confidence: 99%

Variations in Microanatomy of the Human Modiolus: Implications for Cochlear Implants

Pietsch

Schurzig

Salcher

et al. 2021

Preprint

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Human cochlear anatomy is highly variable. The phenomenon has been first described qualitatively, followed by a quantitative variability assessment with detailed anatomical models of the human cochlea. However, all previous work focused on lateral cochlear wall. Few information is available on the variability of the modiolar wall. Modiolar variability, likely determined by variability in the spiral ganglion, provides key information on when during ontogenesis the individual cochlear morphology is established: before and/or after neuronal structures are formed. In the present study we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Lateral wall measures correlated with modiolar wall measures significantly. ~49% of the variability has a common cause, very likely established already during the time when the spiral ganglion is formed. Proximity of other neuronal and vascular structures, defining the remaining variability in scalar spaces, are determined later in ontogenesis, when the scalae are formed. The present data further allows implications for perimodiolar cochlear implants and their tip fold-overs. In particular, the data demonstrate that tip fold-overs of preformed implants likely result from the morphology of the modiolus (with radius changing from base to apex), and that optimal cochlear implantation of perimodiolar arrays cannot be guaranteed without an individualized surgical technique.

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Effect of Electrode to Modiolus Distance on Electrophysiological and Psychophysical Parameters in CI Patients With Perimodiolar and Lateral Electrode Arrays

Cited by 15 publications

References 15 publications

Evaluation of hearing preservation in adults with a slim perimodiolar electrode

Evaluation of hearing preservation in adults with a slim perimodiolar electrode

Variations in microanatomy of the human modiolus require individualized cochlear implantation

Variations in Microanatomy of the Human Modiolus: Implications for Cochlear Implants

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