Safety and feasibility of initial frequency mapping within 24 hours after cochlear implantation

Chen, Joshua Kuang‐Chao; Chuang, Ann Yi-Chiun; Sprinzl, Georg Mathias; Tung, Tao‐Hsin; Li, Lieber Po‐Hung

doi:10.3109/00016489.2015.1006335

Cited by 17 publications

(22 citation statements)

References 18 publications

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“…Early activation within 24 hours after surgery has been reported by our hospital [9, 12] and others [10]. A minimal access approach is critical to facilitate initial switch-on within 1 day, as this can help to minimize the degree of postoperative swelling [12]. In our series, all of the patients tolerated early activation without any complications.…”

Section: Discussionmentioning

confidence: 51%

“…However, various studies investigating early activation have been published and shown the safety, feasibility and residual hearing preservation [9–12, 18, 19]. Early activation within 24 hours after surgery has been reported by our hospital [9, 12] and others [10]. A minimal access approach is critical to facilitate initial switch-on within 1 day, as this can help to minimize the degree of postoperative swelling [12].…”

Section: Discussionmentioning

confidence: 99%

“…The surgical technique with a small incision for cochlear implantation that we use in our department has been described in detail in our previous studies [9, 12]. In brief, the surgery involved a 2.5- to 3-cm postauricular incision, drilling of a bone housing for the receiver-stimulator, harvesting of a cortex bone chip from the mastoid using minimal mastoidectomy, posterior tympanostomy, and hyaluronic acid gel coverage of the cochleostomy before array insertion.…”

Section: Methodsmentioning

confidence: 99%

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Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Chen

Tsai

et al. 2017

PLoS ONE

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ObjectivesChanges in impedance between 24 hours and one month after cochlear implantation have never been explored due to the inability to switch on within one day. This study examined the effect of early activation (within 24 hours) on the evolution of electrode impedance with the aim of providing information on the tissue-to-electrode interface when electrical stimulation was commenced one day post implantation.MethodsWe performed a retrospective review at a single institution. Patients who received a Nucleus 24RECA implant system (Cochlear, Sydney, Australia) and underwent initial switch-on within 24 hours postoperatively were included. Impedance measurements were obtained intraoperatively and postoperatively at 1 day, 1 week, 4 weeks, and 8 weeks.ResultsA significant drop in impedance was noted 1 day after an initial activation within 24 hours followed by a significant rise in impedance in all channels until 1 week, after which the impedance behaved differently in different segments. Basal and mid-portion electrodes revealed a slight increase while apical electrodes showed a slight decrease in impedance from 1 week to 8 weeks postoperatively. Impedance was relatively stable 4 weeks after surgery.ConclusionsThis is the first study to report the evolution of impedance in all channels between initial mapping 1 day and 1 month after cochlear implantation. The underlying mechanism for the differences in behavior between different segments of the electrode may be associated with the combined effect of dynamics among the interplay of cell cover formation, electrical stimulation, and fibrotic reaction.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Chen

Tsai

et al. 2017

PLoS ONE

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“…Having established potential rationale for elevated impedance in patients with EVA, perhaps the most vexing issue remains the rapid decrease in impedance in patients with EVA to levels commensurate with controls. For all patients, such early (24 h) rapid drops in impedance have been observed and reported in our previous work and verified again here (5,19,20). Theorized contributing factors were reviewed above.…”

Section: Discussionsupporting

confidence: 85%

Early Elevation and Normalization of Electrode Impedance in Patients With Enlarged Vestibular Aqueduct Undergoing Cochlear Implantation

Wei

Chen

et al. 2022

Otology &Amp; Neurotology

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Objective: To characterize early changes in impedance in patients undergoing cochlear implantation with and without enlarged vestibular aqueducts (EVA). Methods: Case-control retrospective study of patients undergoing cochlear implantation with and without EVA. Impedance was measured across all channels intraoperatively and within 24 hours of surgery. All patients received the same electrode array. Results: Ten patients with EVA (and matched controls were identified). The average intraoperative impedance across all electrodes was significantly higher in patients with EVA (13.1 AE 1.4 kV) than in controls (9.6 AE 2.5 kV, p < 0.001). At 24-hour activation, the average impedance across all electro-des was roughly equal in both groups (6.8 AE 2.7 kV versus 6.5 AE 2.1 kV, p ¼ 0.72) Conclusions: This study is the first identify differences in intraoperative impedance between patients with and without EVA. In addition, these data demonstrate rapid normalization within 24 hours of surgery. Such findings can give a window of insight into both the intracochlear microenvironment of patients with EVA and the important early electrode-fluidtissue interface changes that occur within hours of surgery for all patients.

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“…Therefore, it can be inferred that the timing of device activation after implantation can also affect the change in impedance. Since the e cacy and safety of early switch-on within 24 h of surgery has previously been con rmed 17 , many CI centers, including ours, have changed the switch-on protocol over the past few years from the initial tting at 3-6 weeks post-surgery to the day after surgery. Previous studies investigating the evolution of electrode impedance after early switch-on have shown inconsistent results according to the type of electrode array [18][19][20] .…”

Section: Introductionmentioning

confidence: 98%

Effect of Initial Switch-On Within 24 Hours of Cochlear Implantation Using Slim Modiolar Electrodes: Potential Clinical Implications

Sunwoo

Jeon

Choi

2021

Preprint

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Reducing electrode impedance is an important factor in improving the functional benefits of cochlear implants (CIs). The immediate effect of early switch-on within 24 hours of surgery on impedance among CI recipients with various types of electrodes has been reported previously; however, the immediate change and the evolution of electrode impedances of slim modiolar electrodes after early switch-on within 24 hours of implantation has not. Therefore, the focus of this study was to compare the effect of early switch-on and conventional switch-on 3–4 weeks post-operation on impedance. Compared with impedance measured intraoperatively, our results demonstrate a significant drop in impedance for early switch-on, which sharply contrasted with elevated impedance values for conventional switch-on 3–4 weeks after implantation. Notably, a comparatively lower impedance than the conventional switch-on protocol was observed for up to 2 months post-operation. Most importantly, a much earlier stabilization of impedance can be achieved with the early switch-on protocol coupled with the slim modiolar electrode array compared to the conventional switch-on protocol, offering the advantage of reducing the number of required mapping sessions in the early stages of rehabilitation.

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Safety and feasibility of initial frequency mapping within 24 hours after cochlear implantation

Abstract: Initial switch-on within 24 h was done in all patients. Good hearing gain was obtained. No major complication occurred. There was no significant difference in hearing postoperatively that was attributable to the early switch-on.

Cited by 17 publications

References 18 publications

Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Evolution of impedance field telemetry after one day of activation in cochlear implant recipients

Early Elevation and Normalization of Electrode Impedance in Patients With Enlarged Vestibular Aqueduct Undergoing Cochlear Implantation

Effect of Initial Switch-On Within 24 Hours of Cochlear Implantation Using Slim Modiolar Electrodes: Potential Clinical Implications

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