Effect of exceeding compliance voltage on speech perception in cochlear implants

Saoji, Aniket A.; Adkins, Weston J.; Olund, Amy P.; Nelson-Bakkum, Erin R.; Koka, Kanthaiah

doi:10.1016/j.heares.2020.108112

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…Also, Saoji et al found there is a significant derivation of speech perception as the effect of implant use exceeding the compliance limit [9].…”

Section: N Ainimentioning

confidence: 99%

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

Aini¹

2022

IJOHNS

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Introduction: Early stimulation of the auditory sense is essential for the development of language and speech. In children with a cochlear implant, the most common issue is whether the hearing has been optimized or not, as they are still unable to provide reliable feedback regarding their hearing ability. Thus, electrically evoked stapedius reflex threshold (ESRT) based fitting has been used as one of the available methods in programming a cochlear implant (CI) audio processor. As eSRT is an objective test, patient cooperation was not needed making it especially beneficial for children with CI who have limitations in providing feedback. Now that eSRT has been applied commonly almost worldwide, the goal of this study is to determine the normative value of eSRT among the pediatric population in Indonesia. Methods: A total of 32 pediatric CI users in the age range 3 -11 years implanted with Med-El cochlear implant were included in this study. ESRT was performed during follow-up mapping between September 2021 and January 2022 in the Med-El Indonesia hearing center. Results: The result of the present study showed an average normative value of 20.55 qus. This finding is consistent with the values obtained in previous studies. Conclusion: The result found can be used as a valuable indicator of average optimised MCL among the pediatric population.

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“…Also, Saoji et al found there is a significant derivation of speech perception as the effect of implant use exceeding the compliance limit [9].…”

Section: N Ainimentioning

confidence: 99%

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

Aini¹

2022

IJOHNS

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“…This perimodiolar (PM) placement helps minimize the amount of current needed to activate the auditory nerve (1,2,8,10) and potentially offers more focused stimulation (11). Given the relationship between current, impedances, and compliance, minimizing current may be advantageous for maintaining stimulation rate, sound quality, and battery life (10,12). In addition, electrodes positioned closer to the modiolus have been correlated with better word recognition (5,6), improved electrode discrimination (13,14), and reduced listening effort (13).…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Comparison of 1-yr Functional Outcomes and Programming Differences Between the Advanced Bionics Mid-Scala and SlimJ Electrode Arrays

Eitutis,

Vickers,

Tebbutt

et al. 2023

Otol Neurotol

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Objective To determine if there is a difference in hearing outcomes or stimulation levels between Advanced Bionics straight and precurved arrays. Study design Retrospective chart review across three implant centers. Setting Tertiary centers for cochlear and auditory brainstem implantation. Patients One hundred fifteen pediatric and 205 adult cochlear implants (CIs) were reviewed. All patients were implanted under the National Institute for Health and Care Excellence 2009 guidelines with a HiRes Ultra SlimJ or Mid-Scala electrode array. Main outcome measures Hearing preservation after implantation, as well as CI-only listening scores for Bamford-Kowal-Bench sentences were compared 1 year after implantation. Stimulation levels for threshold and comfort levels were also compared 1 year after implantation. Results Hearing preservation was significantly better with the SlimJ compared with the Mid-Scala electrode array. Bamford-Kowal-Bench outcomes were not significantly different between the two arrays in any listening condition. Stimulation levels were not different between arrays but did vary across electrode contacts. At least one electrode was deactivated in 33% of implants but was more common for the SlimJ device. Conclusion Modern straight and precurved arrays from Advanced Bionics did not differ in hearing performance or current requirements. Although hearing preservation was possible with both devices, the SlimJ array would still be the preferred electrode in cases where hearing preservation was a priority. Unfortunately, the SlimJ device was also prone to poor sound perception on basal electrodes. Further investigation is needed to determine if deactivated electrodes are associated with electrode position/migration, and if programming changes are needed to optimize the use of these high-frequency channels.

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“…Typically, cochlear implant (CI) electrode impedances can fluctuate between clinical visits. However, any changes of 4 kΩ or greater are considered significant (1). Very little is known when there is a sudden increase in CI electrode impedances after the common postactivation time frame of approximately 6 months.…”

Section: Introductionmentioning

confidence: 99%

“…The authors concluded that the CI impedance fluctuation could be related to changes in electrical resistance between scala tympani and blood associated with periodic immune activity in the inner ear. CI electrode impedance values are found to greatly influence the speech perception ability of CI patients (1). Increasing CI impedances leads to high electrical stimulation voltage, causing electrodes to become out of compliance and clipping to occur.…”

Section: Introductionmentioning

confidence: 99%

Electrode Impedance Fluctuations and Sudden Decline in Cochlear-Implant Benefit

Pitt

Nagaraj²,

Salisbury³

2022

Otol Neurotol

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ObjectiveThe main objective of this clinical capsule was to outline the narrative of three teen cochlear implant (CI) users who experienced a sudden increase in their CI electrode impedance values, which coincided with decreased overall speech perception ability. In addition, the study explored the following questions: Are there any similarities between cases? What recommendations should be made for continuing treatment regarding these cases?PatientsThree teenagers who reported sudden change in CI benefit were included in this study.InterventionsElectrode impedance values and speech identification scores were obtained routinely during the CI mapping appointments. Specifically, word and sentence recognition scores were obtained using the Consonant-Nucleus-Consonant word list and the AZBio sentence test, respectively. Both patient 1 and patient 2 underwent CI reimplantation operations as a result of their perceived difficulties and decreased impedances. Patient 3 did not undergo reimplantation surgery.Main OutcomesAll three patients' CI electrode impedances and speech perception scores eventually stabilized over time. No relationship could be drawn between revision surgery and stabilization of CI electrode impedances and speech perception scores.ConclusionsOverall, we found no similarities between cases that could potentially explain the sudden electrode impedance value increase or the decrease in speech perception scores. Each case should be evaluated uniquely and carefully for CI revision operations by frequent monitoring, including mapping and speech perception testing. The most common factor contributing to each teen's eventual resolution of electrode impedance values and speech perception scores was time.

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Effect of exceeding compliance voltage on speech perception in cochlear implants

Cited by 8 publications

References 24 publications

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

Normative eSRT Value among MED-EL Pediatric Population in Indonesia

A Multicenter Comparison of 1-yr Functional Outcomes and Programming Differences Between the Advanced Bionics Mid-Scala and SlimJ Electrode Arrays

Electrode Impedance Fluctuations and Sudden Decline in Cochlear-Implant Benefit

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