Evaluation of Outcome Variability Associated With Lateral Wall, Mid-scalar, and Perimodiolar Electrode Arrays When Controlling for Preoperative Patient Characteristics

Fabie, Joshua E.; Keller, Robert; Hatch, Jonathan L.; Holcomb, Meredith A.; Camposeo, Elizabeth L.; Lambert, Paul R.; Meyer, Ted A.; McRackan, Theodore R.

doi:10.1097/mao.0000000000001951

Cited by 32 publications

(44 citation statements)

References 30 publications

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“…In line with the current literature, the study found that both precurved and straight electrodes are clinically effective for cochlear implantation [22]. Both the precurved and straight electrode cohorts demonstrated varied speech outcome improvement, and mean difference scores between the two groups were not significantly different at 12 months (P > .05).…”

Section: Discussionsupporting

confidence: 85%

“…Reasons for these differences are puzzling and could be due to the use of larger precurved arrays and not newer thinner precurved arrays allowing for differences in intracochlear trauma from insertion. However, CNC speech outcome results from the study support previous works suggesting that selection of the electrode should be made by the surgeon independent of preconceived notions of electrode superiority [ 9 , 22 ]. The present analysis demonstrated that sex did not significantly affect speech outcomes in patients, which conflicts with findings from a 2019 analysis of 55 patients by Raymond and colleagues showing higher relative postoperative improvement for female cochlear implant recipients [ 23 ].…”

Section: Discussionsupporting

confidence: 81%

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Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program

Aminpour¹,

Levin²,

Finkbone³

et al. 2022

Cureus

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Introduction: The use of cochlear implantation to rehabilitate moderate to profound sensorineural hearing loss has become more widespread; however, the adult utilization rate of cochlear implant candidates is still very less. The study aims to examine the percentage of adult patients in a heterogeneous group of cochlear implant recipients at a nascent cochlear implant program who demonstrate improvements in speech outcomes.Methods: Speech outcome scores were assessed preoperatively and postoperatively at three, six, and 12month intervals using consonant-nucleus-consonant (CNC) words and AzBio sentences in quiet. Mean speech outcome scores at each time point and binomial distribution tables with 95% CI were used to assess individual improvement in speech understanding.Results: 45 patients underwent a total of 49 cochlear implantation surgeries. The mean age at surgery was 62 years. The mean preoperative CNC score in the ear to be implanted was 18%±18, while the mean postoperative CNC score at three, six, and 12 months was 35%±21, 44%±23, and 45%±25, respectively. The mean preoperative AzBio score in the ear to be implanted was 22%±26 while the mean postoperative AzBio score at three, six, and 12 months was 50%±29, 56%±27, and 63%±26, respectively. Of the implantations, 74% (32 of 43) and 69% (22 of 32) showed significant improvement at six months or one year using AzBio and CNC binomial distribution tables, respectively. Conclusions: Findings demonstrate significant improvements in speech perception following cochlear implantation for patients not benefiting from hearing aid aural rehabilitation. The study provides realistic expectations for new and emerging programs hoping to demonstrate cochlear implant utility for improving patients' speech outcomes.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 81%

Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program

Aminpour¹,

Levin²,

Finkbone³

et al. 2022

Cureus

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“…13 It has been theorized that for patients with little to no residual hearing, a PM electrode should be chosen to provide greater electrode apposition to the spiral ganglion neurons, less energy usage, and greater overall speech understanding. 13 Prior studies have demonstrated that LFPTA <80 dB is the postoperative threshold indicative of preserved low-frequency hearing. 15 As our patients tended to have poor preoperative LFPTA (mean [SD], 75.5 [20.9] for SLW and 78.3 [17.9] for SME), very few patients in our cohort would have qualified for hearing preservation.…”

Section: Discussionmentioning

confidence: 99%

Speech Recognition Outcomes in Adults With Slim Straight and Slim Modiolar Cochlear Implant Electrode Arrays

MacPhail

Connell²,

Totten³

et al. 2021

Otolaryngol.--head neck surg.

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Objective To compare differences in audiologic outcomes between slim modiolar electrode (SME) CI532 and slim lateral wall electrode (SLW) CI522 cochlear implant recipients. Study Design Retrospective cohort study. Setting Tertiary academic hospital. Methods Comparison of postoperative AzBio sentence scores in quiet (percentage correct) in adult cochlear implant recipients with SME or SLW matched for preoperative AzBio sentence scores in quiet and aided and unaided pure tone average. Results Patients with SLW (n = 52) and patients with SME (n = 37) had a similar mean (SD) age (62.0 [18.2] vs 62.6 [14.6] years, respectively), mean preoperative aided pure tone average (55.9 [20.4] vs 58.1 [16.4] dB; P = .59), and mean AzBio score (percentage correct, 11.1% [13.3%] vs 8.0% [11.5%]; P = .25). At last follow-up (SLW vs SME, 9.0 [2.9] vs 9.9 [2.6] months), postoperative mean AzBio scores in quiet were not significantly different (percentage correct, 70.8% [21.3%] vs 65.6% [24.5%]; P = .29), and data log usage was similar (12.9 [4.0] vs 11.3 [4.1] hours; P = .07). In patients with preoperative AzBio <10% correct, the 6-month mean AzBio scores were significantly better with SLW than SME (percentage correct, 70.6% [22.9%] vs 53.9% [30.3%]; P = .02). The intraoperative tip rollover rate was 8% for SME and 0% for SLW. Conclusions Cochlear implantation with SLW and SME provides comparable improvement in audiologic functioning. SME does not exhibit superior speech recognition outcomes when compared with SLW.

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“…On the contrary, other studies report better speech perception outcomes for the PM group (7,15). The majority of the studies, however, showed no difference between both groups (18)(19)(20)(21)(22). However, all these studies had a high risk of bias.…”

Section: Introductionmentioning

confidence: 93%

Evaluating cochlear insertion trauma and hearing preservation after cochlear implantation (CIPRES): A study protocol for a randomised single blind controlled trial

Jwair¹,

Boerboom²,

Versnel³

et al. 2020

Preprint

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BackgroundIn order to preserve residual hearing in patients with sensorineural hearing loss (SNHL) who receive a cochlear implant (CI), insertion trauma to the delicate structures of the cochlea needs to be minimized. The surgical approach comprises the conventional mastoidectomy-posterior tympanotomy (MPT) to arrive at the middle ear, followed by either a cochleostomy (CO) or the round window (RW) approach. Both techniques have their benefits and disadvantages. Another important aspect in structure preservation is the design of the electrode array. Two different designs are used: a ‘straight’ lateral wall lying electrode array (LW), or a ‘pre-curved’ perimodiolar lying electrode array (PM). Interestingly, until now, the best surgical approach and design of the implant is uncertain. Our hypothesis is that the combination of a RW approach and a LW lying electrode array minimizes insertion trauma, leading to better hearing outcome for SNHL patients. MethodsWe designed a monocenter, 2x2, randomized controlled trial to compare insertion trauma between four groups of patients, with each group having a unique combination of electrode array type (LW or PM) and surgical approach (RW or CO). In total, 48 patients will be randomized into one of these four intervention groups. Our primary objective is comparison of postoperative hearing preservation between these four groups. Secondly, we aim to assess structure preservation (i.e., scalar transposition, with basilar membrane disruption or tip fold-over of array) for each group. Thirdly, we will compare objective outcomes of hearing and structure preservation by way of electrocochleography (ECochG).DiscussionCochlear implantation by way of a cochleostomy or round window approach, using different electrode array types, is the standard medical care for patients with severe to profound bilateral sensorineural hearing loss, as it is a relative simple and low-risk procedure that greatly benefits patients. However, loss of residual hearing remains a problem. This trial is the first randomized controlled trial that evaluates the effect of cochlear insertion trauma of several CI treatment options on hearing preservation. Trial registrationThis trial is registered in the Netherlands Trial Register (NTR) (www.trialregister.nl): NL8586, date of registration: 4th of May 2020. Retrospectively registered; 3/48 participants were included before registration.

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Evaluation of Outcome Variability Associated With Lateral Wall, Mid-scalar, and Perimodiolar Electrode Arrays When Controlling for Preoperative Patient Characteristics

Cited by 32 publications

References 30 publications

Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program

Review of Speech Outcomes in Cochlear Implant Recipients at a Nascent Cochlear Implant Program

Speech Recognition Outcomes in Adults With Slim Straight and Slim Modiolar Cochlear Implant Electrode Arrays

Evaluating cochlear insertion trauma and hearing preservation after cochlear implantation (CIPRES): A study protocol for a randomised single blind controlled trial

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