Neural tonotopy in cochlear implants: An evaluation in unilateral cochlear implant patients with unilateral deafness and tinnitus

Vermeire, Katrien; Nobbe, Andrea; Schleich, P.; Nopp, Peter; Voormolen, Maurits; Heyning, Paul Van de

doi:10.1016/j.heares.2008.09.003

Cited by 74 publications

(71 citation statements)

References 19 publications

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“…A negative relation with performance may only be detectable in cases of extreme positioning, either very shallow or very deep insertions, for which the specific implant type is not configured. Indeed, in studies of patients with a Med-El Combi40+ electrode, much deeper insertion depths with averages around 630° are described [Baumann and Nobbe, 2006;Gani et al, 2007;Hamzavi and Arnoldner, 2006;Kos et al, 2005;Radeloff et al, 2008;Vermeire et al, 2008], yet speech perception outcomes remain comparable to those reported with HiFocus implants. This supports the hypothesis that not factors such as electrode length, contact number or intercontact spacing, but rather large discrepancies between the implant configuration (which frequencies are stimulated by which contact) and the position within the cochlea affect performance.…”

Section: Discussionmentioning

confidence: 95%

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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Section: Discussionmentioning

confidence: 95%

The Influence of Cochlear Implant Electrode Position on Performance

Marel¹,

Briaire²,

Verbist

et al. 2015

Audiol Neurotol

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“…Indeed, electroacoustic stimulation users benefit from acoustic auditory input that may help in reducing the mismatch, whereas no such physiological auditory references come into play with electrical stimulation. Based on results of functional imaging [Lazard et al, 2014] and of pitch matching studies in patients implanted for a single-sided deafness who displayed almost no mismatch [Vermeire et al, 2008], one can hypothesize that patients with profound hearing loss, having lost any possibility of pitch recognition and matching, have reduced opportunities to develop plasticity than do patients with functional residual hearing. This point could be further addressed by studying patients with a short duration of profound deafness in whom brain plasticity would be less likely to have altered.…”

Section: Discussionmentioning

confidence: 99%

Effects of Electrode Array Length on Frequency-Place Mismatch and Speech Perception with Cochlear Implants

et al. 2015

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Frequency-place mismatch often occurs after cochlear implantation, yet its effect on speech perception outcome remains unclear. In this article, we propose a method, based on cochlea imaging, to determine the cochlear place-frequency map. We evaluated the effect of frequency-place mismatch on speech perception outcome in subjects implanted with 3 different lengths of electrode arrays. A deeper insertion was responsible for a larger frequency-place mismatch and a decreased and delayed speech perception improvement by comparison with a shallower insertion, for which a similar but slighter effect was noticed. Our results support the notion that selecting an electrode array length adapted to each individual's cochlear anatomy may reduce frequency-place mismatch and thus improve speech perception outcome.

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“…However, caution is required in interpreting these results, as there is some uncertainty in the determination of the tinnitus pitchmatched electrode via the used method. For example, no postoperative X-rays were available from each subject to determine the tinnitus pitch-matched electrode on the basis of the tinnitus pitch and electrode location [Boëx et al, 2006;Vermeire et al, 2008]. Furthermore, it is not exactly known whether stimulation targets the nerve fibers at the level of the organ of Corti or the spiral ganglion cells within Rosenthal's canal.…”

Section: Effect Of Stimulation Sitementioning

confidence: 99%

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I

et al. 2015

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Cochlear implantation is a viable treatment option for tinnitus, but the underlying mechanism is yet unclear. Is the tinnitus suppression due to the reversal of the assumed maladaptive neuroplasticity or is it the shift in attention from the tinnitus to environmental sounds and therefore a reduced awareness that reduces tinnitus perception? In this prospective trial, 10 patients with single-sided deafness were fitted with a cochlear implant to investigate the effect of looped intracochlear electrical stimulation (i.e. stimulation that does not encode environmental sounds) on tinnitus, in an effort to find optimal stimulation parameters. Variables under investigation were: amplitude (perceived stimulus loudness), anatomical location inside the cochlea (electrode/electrodes), amplitude modulation, polarity (cathodic/anodic first biphasic stimulation) and stimulation rate. The results suggest that tinnitus can be reduced with looped electrical stimulation, in some cases even with inaudible stimuli. The optimal stimuli for tinnitus suppression appear to be subject specific. However, medium-to-loud stimuli suppress tinnitus significantly better than soft stimuli, which partly can be explained by the masking effect. Although the long-term effects on tinnitus would still have to be investigated and will be described in part II, intracochlear electrical stimulation seems a potential treatment option for tinnitus in this population.

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Neural tonotopy in cochlear implants: An evaluation in unilateral cochlear implant patients with unilateral deafness and tinnitus

Cited by 74 publications

References 19 publications

The Influence of Cochlear Implant Electrode Position on Performance

The Influence of Cochlear Implant Electrode Position on Performance

Effects of Electrode Array Length on Frequency-Place Mismatch and Speech Perception with Cochlear Implants

Tinnitus Suppression by Intracochlear Electrical Stimulation in Single-Sided Deafness: A Prospective Clinical Trial - Part I

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