Safety and Functional Results of Early Cochlear Implant Switch-On in Children

Marsella, Pasquale; Scorpecci, Alessandro; Pacifico, Concettina; Resca, Alessandra; Vallarino, Maria Vittoria; Ingrosso, Angelo; Luchenti, Stefania

doi:10.1097/mao.0000000000000259

Cited by 26 publications

(38 citation statements)

References 15 publications

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“…The impedance, the impedance in all portions of the electrodes, and residual hearing preservation rate in both the early activation and control groups were not significantly different. Marsella et al had a similar conclusion in their study, though the “early activation” was conducted 1 week after CI surgery. In their 9‐month follow‐up period, they also found that the early switch‐on was well tolerated by patients and did not cause complications.…”

Section: Discussionsupporting

confidence: 55%

Feasibility of early activation after cochlear implantation

Sun

Chang

Hsu

et al. 2019

Clinical Otolaryngology

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Objectives The purpose of the study is to investigate feasibility of early activation after cochlear implantation by evaluating long‐term impedance change and speech perception. Design Case‐control study Setting Between July 2015 and December 2016, we prospectively enrolled 20 subjects for early activation (within 24 hours after cochlear implantation). On the other hand, from November 2013 to July 2015, 20 age‐ and sex‐matched control subjects from the database of cochlear implantees treated with conventional activation schedule (4 weeks after surgery) were retrospectively enrolled. Participant Forty patients who underwent cochlear implantation surgeries. Main outcome measures The series impedance and speech perception score of both groups were compared. Results No statistical difference in long‐term follow‐up between the two groups was found using GEEs and multivariate analysis. In the early activation group, impedance reached a steady level by the 2nd postoperative week, and the hearing perception ability significantly improved by the 4th postoperative week. Conclusion This comparative study illustrated sequential impedance data during early activation (24 hours) and conventional activation (4 weeks) after CI surgery. There were no major complications in either group, and the safety of early activation with respect to impedance changes, postoperative residual hearing preservation and speech perception scores were non‐inferior to that of the conventional group. Therefore, in this study, we established the feasibility of early activation 24 hours after cochlear implantation.

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Section: Discussionsupporting

confidence: 55%

Feasibility of early activation after cochlear implantation

Sun

Chang

Hsu

et al. 2019

Clinical Otolaryngology

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“…This suggests a delicate balance between cell cover formation, a divergence effect with electrical stimulation, and pro- and anti-fibrotic cytokines [29]. The further evolution of impedance after 2 months has been reported in several studies with no significant changes in adults [8, 15, 18, 19]. …”

Section: Discussionmentioning

confidence: 92%

“…A possible explanation for this is rearrangement of the milieus surrounding the electrode array after surgery [19]. For example, air bubbles generated by electrode insertion may have led to high intraoperative impedance values which then resolved quickly after implantation [18].…”

Section: Discussionmentioning

confidence: 99%

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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“…This has been shown by numerous studies [Busby et al, 2002;Marsella et al, 2014;Newbold et al, 2013;Zadrozniak et al, 2011] and can be explained by the fact that electrical stimulation results in an electrochemical cleaning (depassivation) of the platinum-iridium electrode contacts (conditioning process), in an increase in the effective electrode surface and in a decrease in the capacitive part of the electrode-electrolyte impedance. The same conditioning effects obviously occur at the basal electrodes, yet these electrodes show a completely different behaviour postoperatively.…”

Section: Discussionmentioning

confidence: 91%

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

Molisz

Zarowski²,

Vermeiren³

et al. 2015

Audiol Neurotol

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Objective: To evaluate the postoperative changes of the basic electrophysiological and psychophysical parameters in cochlear implant (CI) patients: the impedance of the electrode contacts, the electrically-evoked compound action potential (ECAP) thresholds and the T/C levels. Study Design and Setting: Retrospective case review in a quaternary otologic referral centre. Materials and Methods: Data on the impedance of the electrode contacts, the ECAP thresholds and the T/C levels were collected in 20 consecutive CI patients divided into 2 groups. Group 1 comprised 10 prelingually deaf children implanted before the age of 18 months, and group 2 comprised 10 postlingually deaf adults (average age of 58 years). All patients were users of the Nucleus 24RECA (Freedom, Contour advance off-stylet electrode) CI. Results and Conclusions: (1) The mid-portion and the apical electrodes showed a decrease in the impedance values between the 1st and the 6th postoperative months and stabilization in the later course. Impedance of the most basal electrodes grew during the first postoperative months and stabilized later on, but remained higher than the impedance of the mid-portion and the apical electrodes. (2) The neural response telemetry threshold values tended to decrease within the first 3 months after surgery to reach a plateau afterwards. (3) The behavioural threshold levels remained generally stable, except for the basal electrodes where a decrease could be observed. The hearing comfort levels showed an increase during the first 6 months of the implant use and remained stable afterwards.

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Safety and Functional Results of Early Cochlear Implant Switch-On in Children

Cited by 26 publications

References 15 publications

Feasibility of early activation after cochlear implantation

Feasibility of early activation after cochlear implantation

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

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

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