Preservation of cochlear structures and hearing when using the Nucleus Slim Straight (CI422) electrode in children

Skarżyński, Henryk; Matusiak, Monika; Lorens, Artur; Furmanek, Mariusz; Piłka, Adam

doi:10.1017/s0022215115003436

Cited by 32 publications

(16 citation statements)

References 27 publications

(56 reference statements)

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“…Previous studies have demonstrated the benefits associated with low frequency acoustic hearing, but given current resources, surgeons are able to achieve hearing preservation—defined as postoperative audiometric thresholds within 10 dB of preoperative levels—in, at most, 50% of cases (Jurawitz et al, 2014; Santa Maria et al, 2014; Van Abel et al, 2015; Dedhia et al, 2016; Eshraghi et al, 2016; Skarzynski et al, 2016). The pathophysiology of hearing loss during and following surgery is still largely unknown, but it is believed to be a result of (1) intraoperative physical trauma including fracture of the osseous spiral lamina, trans-scalar dislocation, and/or insult to spiral ligament or stria vascularis and/or (2) postoperative inflammatory responses and subsequent fibrosis, neo-osteogenesis and/or cellular apoptosis (e.g., Eshraghi and Van de Water, 2006; Eshraghi et al, 2013; Kamakura and Nadol, 2016).…”

Section: Introductionmentioning

confidence: 99%

Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation

et al. 2017

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Introduction: The objectives of the current study were to (1) determine the relationship between electrocochleography (ECochG), measured from the cochlear implant (CI) electrode array during and after implantation, and postoperative audiometric thresholds, (2) determine the relationship between ECochG amplitude and electrode scalar location determined by computerized tomography (CT); and (3) determine whether changes in cochlear microphonic (CM) amplitude during electrode insertion were associated with postoperative hearing.Materials and Methods: Eighteen subjects undergoing CI with an Advanced Bionics Mid-Scala device were prospectively studied. ECochG responses were recorded using the implant coupled to a custom signal recording unit. ECochG amplitude collected intraoperatively concurrent with CI insertion and at activation was compared with audiometric thresholds postoperatively. Sixteen patients also underwent postoperative CT to determine scalar location and the relationship to ECochG measures and residual hearing.Results: Mean low-frequency pure tone average (LFPTA) increased following surgery by an average of 28 dB (range 8–50). Threshold elevation was significantly greater for electrodes with scalar dislocation. No correlation was found between intraoperative ECochG and postoperative behavioral thresholds collapsed across frequency; however, mean differences in thresholds measured by intraoperative ECochG and postoperative audiometry were significantly smaller for electrodes inserted completely within scala tympani (ST) vs. those translocating from ST to scala vestibuli. A significant correlation was observed between postoperative ECochG thresholds and behavioral thresholds obtained at activation.Discussion: Postoperative audiometry currently serves as a marker for intracochlear trauma though thresholds are not obtained until device activation or later. When measured at the same time-point postoperatively, low-frequency ECochG thresholds correlated with behavioral thresholds. Intraoperative ECochG thresholds, however, did not correlate significantly with postoperative behavioral thresholds suggesting that changes in cochlear physiology occur between electrode insertion and activation. ECochG may hold clinical utility providing surgeons with feedback regarding insertion trauma due to scalar translocation, which may be predictive of postoperative hearing preservation.Conclusion: CI insertion trauma is generally not evident until postoperative audiometry when loss of residual hearing is confirmed. ECochG has potential to provide estimates of trauma during insertion as well as reliable information regarding degree of hearing preservation.

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Section: Introductionmentioning

confidence: 99%

Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation

et al. 2017

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“…Over a period of 3 years, monosyllabic word recognition increased from 60 to 95% under quiet conditions and from 15 to 40% under noisy conditions. Patient A.III.9 with bilateral mild-to-profound HL obtained CI [CI24RE (SRA); Cochlear, Melbourne, Australia] in the RE at the age of 18 years ( 44 ). Before surgery the monosyllabic speech discrimination in quiet and noise in the bilaterally best fitted HAs was 30 and 0%, respectively.…”

Section: Resultsmentioning

confidence: 99%

Application of next‑generation sequencing to identify mitochondrial mutations: Study on m.7511T>C in patients with hearing loss

et al. 2017

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Interruptions in the activity of mitochondria induced by mutations in the mitochondrial genome (mtDNA) can be the source of numerous diseases including hearing loss (HL). One of the mitochondrial variants responsible for HL is the m.7511T>C mutation located in the mitochondrially encoded tRNA serine 1 (UCN) gene. Next-generation sequencing was used to search for the HL mutations in the whole mtDNA of 2 patients with maternal inheritance and real time-polymerase chain reaction was applied for population screening of the m.7511T>C mutation in a group of 1,644 patients with HL. Sequencing of the whole mtDNA in 2 probands revealed a homoplasmic m.7511T>C mutation. Inheritance of the m.7511T>C mutation has been confirmed in examined matrilineal relatives in both families. The mean age of HL onset was 14.1 years old with the mean degree of HL equaling 74.8 dB. A large-scale search for the m.7511T>C mutation among the patients with HL established the frequency of the m.7511T>C mutation at 0.12% among Polish patients with HL. In conclusion, this first report on central European patients harboring the m.7511T>C mutation reveals that the m.7511T>C may be important when diagnosing patients with maternally inherited HL.

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“…straight or pre-curved, full-length or short) and sound processors to choose from, which can facilitate decision making on an individual basis. Proximity to the modiolus [2, 3], electrical current requirements [4], energy consumption, trauma to the cochlea [5], combined electro-acoustic stimulation [6, 7]), preservation of cochlear structures with low-trauma surgical technique [3, 8–10] and hearing preservation [11–14] are important aspects of implant design which have become the focus of many discussions and studies.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological measurements with electrode types of different perimodiolar properties and the same cochlear implant electronics – a retrospective comparison study

Perényi

Tóth

Dimák

et al. 2019

Journal of Otolaryngology - Head & Neck Surgery

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Preservation of cochlear structures and hearing when using the Nucleus Slim Straight (CI422) electrode in children

Abstract: Hearing preservation in children implanted with the Nucleus CI422 slim, straight electrode is possible even with 25 mm insertion depth, although the recommended insertion depth is 20 mm. A round window approach using a soft, straight electrode is most conducive to hearing preservation.

Cited by 32 publications

References 27 publications

Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation

Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation

Application of next‑generation sequencing to identify mitochondrial mutations: Study on m.7511T>C in patients with hearing loss

Electrophysiological measurements with electrode types of different perimodiolar properties and the same cochlear implant electronics – a retrospective comparison study

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