scholarly journals Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

2021 ◽  
Author(s):  
Manuel Christoph Ketterer ◽  
Antje Aschendorff ◽  
Susan Arndt ◽  
Rainer Beck
Keyword(s):  
Speech Perception ◽  
Significant Influence ◽  
Electrode Array ◽  
Dislocation Rate ◽  
Speech Discrimination ◽  
Electrode Arrays ◽  
Insertion Depth ◽  
Array Design ◽  
Cochlear Morphology ◽  
Array Position

Abstract Purpose The aim of this study is to examine the scalar dislocation rate in straight and perimodiolar electrode arrays in relation to cochlear morphology. Furthermore, we aim to analyze the specific dislocation point of electrode arrays depending on their design and shape and to correlate these results to postoperative speech perception. Methods We conducted a comparative analysis of patients (ears: n = 495) implanted between 2013 and 2018 with inserted perimodiolar or straight electrode arrays from Cochlear™ or MED-EL. CBCT (cone beam computed tomography) was used to determine electrode array position (scalar insertion, intra-cochlear dislocation, point of dislocation and angular insertion depth). Furthermore, cochlear morphology was measured. The postoperative speech discrimination was compared regarding electrode array dislocation, primary scalar insertion and angular insertion depth. Results The electrode array with the highest rate of primary SV insertions was the CA; the electrode array with the highest rate of dislocations out of ST was the FlexSoft. We did not find significantly higher dislocation rates in cochleostomy-inserted arrays. The angle of dislocation was electrode array design-specific. A multivariate nonparametric analysis revealed that the dislocation of the electrode array has no significant influence on postoperative speech perception. Nevertheless, increasing angular insertion depth significantly reduced postoperative speech perception for monosyllables. Conclusion This study demonstrates the significant influence of electrode array design on scalar location, dislocation and the angle of dislocation itself. Straight and perimodiolar electrode arrays differ from each other regarding both the rate and place of dislocation. Insertion via cochleostomy does not lead to increased dislocation rates in any of the included electrode arrays. Furthermore, speech perception is significantly negatively influenced by angular insertion depth.

scholarly journals Radiological evaluation of a new straight electrode array compared to its precursors

2020 ◽  
Author(s):  
Manuel Christoph Ketterer ◽  
A. Aschendorff ◽  
S. Arndt ◽  
I. Speck ◽  
A. K. Rauch ◽  
...  
Keyword(s):  
Round Window ◽  
Electrode Array ◽  
Lateral Wall ◽  
Study Groups ◽  
Cone Beam ◽  
Special Focus ◽  
Electrode Arrays ◽  
Academic Center ◽  
Cochlear Morphology ◽  
Array Position

Abstract Objective The aim of this study is to examine electrode array coverage, scalar position and dislocation rate in straight electrode arrays with special focus on a new electrode array with 26 mm in lengths. Study design Retrospective study. Setting Tertiary academic center. Patients 201 ears implanted between 2013 and 2019. Main outcome measures We conducted a comparative analysis of patients implanted with lateral wall electrode arrays of different lengths (F24 = MED-EL Flex24, F26 = MED-EL Flex26, F28 = MED-EL Flex28 and F31.5 = MED-EL FlexSoft). Cone beam computed tomography was used to determine electrode array position (scala tympani (ST) versus scala vestibuli (SV), intracochlear dislocation, position of dislocation and insertion angle). Results Study groups show no significant differences regarding cochlear size which excludes influences by cochlear morphology. As expected, the F24 showed significant shorter insertion angles compared to the longer electrode arrays. The F26 electrode array showed no signs of dislocation or SV insertion. The electrode array with the highest rate of ST dislocations was the F31.5 (26.3%). The electrode array with the highest rates of SV insertions was the F28 (5.75%). Most of the included electrode arrays dislocate between 320° and 360° (mean: 346.4°; range from 166° to 502°). Conclusion The shorter F24 and the new straight electrode array F26 show less or no signs of scalar dislocation, neither for round window nor for cochleostomy insertion than the longer F28 and the F31.5 array. As expected, the cochlear coverage is increasing with length of the electrode array itself but with growing risk for scalar dislocation and with the highest rates of dislocation for the longest electrode array F31.5. Position of intracochlear dislocation is in the apical cochlear part in the included lateral wall electrode arrays.

Incidence of Complete Insertion in Cochlear Implant Recipients of Long Lateral Wall Arrays

2021 ◽  
pp. 019459982098745
Author(s):  
Michael W. Canfarotta ◽  
Margaret T. Dillon ◽  
Kevin D. Brown ◽  
Harold C. Pillsbury ◽  
Matthew M. Dedmon ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Electrode Array ◽  
Lateral Wall ◽  
Electrode Arrays ◽  
Tertiary Referral ◽  
Insertion Depth ◽  
Future Studies ◽  
Tertiary Referral Center ◽  
Cochlear Duct Length ◽  
Cochlear Morphology

Objective High rates of partial insertion have been reported for cochlear implant (CI) recipients of long lateral wall electrode arrays, presumably caused by resistance encountered during insertion due to cochlear morphology. With recent advances in long-electrode array design, we sought to investigate (1) the incidence of complete insertions among patients implanted with 31.5-mm flexible arrays and (2) whether complete insertion is limited by cochlear duct length (CDL). Study Design Retrospective review. Setting Tertiary referral center. Methods Fifty-one adult CI recipients implanted with 31.5-mm flexible lateral wall arrays underwent postoperative computed tomography to determine the rate of complete insertion, defined as all contacts being intracochlear. CDL and angular insertion depth (AID) were compared between complete and partial insertion cohorts. Results Most cases had a complete insertion (96.1%, n = 49). Among the complete insertion cohort, the median CDL was 33.6 mm (range, 30.3-37.9 mm), and median AID was 641° (range, 533-751°). Two cases of partial insertion had relatively short CDL (31.8 mm and 32.3 mm) and shallow AID (542° and 575°). Relatively shallow AID for the 2 cases of partial insertion fails to support the idea that CDL alone prevents a complete insertion. Conclusion Complete insertion of a 31.5-mm flexible array is feasible in most cases and does not appear to be limited by the range of CDL observed in this cohort. Future studies are needed to estimate other variations in cochlear morphology that could predict resistance and failure to achieve complete insertion with long arrays.

The influence of cochlear morphology on the final electrode array position

2017 ◽  
Vol 275 (2) ◽  
pp. 385-394 ◽  
Author(s):  
M. C. Ketterer ◽  
A. Aschendorff ◽  
S. Arndt ◽  
F. Hassepass ◽  
T. Wesarg ◽  
...  
Keyword(s):  
Electrode Array ◽  
Cochlear Morphology ◽  
Array Position

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

2015 ◽  
Vol 20 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Frederic Venail ◽  
Caroline Mathiolon ◽  
Sophie Menjot de Champfleur ◽  
Jean Pierre Piron ◽  
Marielle Sicard ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Electrode Arrays ◽  
Frequency Map

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.

scholarly journals CT-Derived Estimation of Cochlear Morphology and Electrode Array Position in Relation to Word Recognition in Nucleus-22 Recipients

2002 ◽  
Vol 3 (3) ◽  
pp. 332-350 ◽  
Author(s):  
Margaret W. Skinner ◽  
Darlene R. Ketten ◽  
Laura K. Holden ◽  
Gary W. Harding ◽  
Peter G. Smith ◽  
...  
Keyword(s):  
Word Recognition ◽  
Electrode Array ◽  
Cochlear Morphology ◽  
Array Position

Comparison of the HiFocus Mid-Scala and HiFocus 1J Electrode Array: Angular Insertion Depths and Speech Perception Outcomes

2016 ◽  
Vol 21 (5) ◽  
pp. 316-325 ◽  
Author(s):  
M. Annerie van der Jagt ◽  
Jeroen J. Briaire ◽  
Berit M. Verbist ◽  
Johan H.M. Frijns
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Electrode Array ◽  
Lateral Wall ◽  
Neural Stimulation ◽  
Insertion Depth ◽  
Optimal Distance ◽  
Frequency Mismatch ◽  
The Mean

The HiFocus Mid-Scala (MS) electrode array has recently been introduced onto the market. This precurved design with a targeted mid-scalar intracochlear position pursues an atraumatic insertion and optimal distance for neural stimulation. In this study we prospectively examined the angular insertion depth achieved and speech perception outcomes resulting from the HiFocus MS electrode array for 6 months after implantation, and retrospectively compared these with the HiFocus 1J lateral wall electrode array. The mean angular insertion depth within the MS population (n = 96) was found at 470°. This was 50° shallower but more consistent than the 1J electrode array (n = 110). Audiological evaluation within a subgroup, including only postlingual, unilaterally implanted, adult cochlear implant recipients who were matched on preoperative speech perception scores and the duration of deafness (MS = 32, 1J = 32), showed no difference in speech perception outcomes between the MS and 1J groups. Furthermore, speech perception outcome was not affected by the angular insertion depth or frequency mismatch.

Electrode Migration in Patients with Perimodiolar Cochlear Implant Electrodes

2015 ◽  
Vol 20 (6) ◽  
pp. 349-353 ◽  
Author(s):  
Philipp Mittmann ◽  
Grit Rademacher ◽  
Sven Mutze ◽  
Arneborg Ernst ◽  
Ingo Todt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Lateral Wall ◽  
Electrode Arrays ◽  
Insertion Depth ◽  
Lower Extent ◽  
Uncommon Complication

Migration of a cochlear implant electrode is a hitherto uncommon complication. So far, array migration has only been observed in lateral wall electrodes. Between 1999 and 2014, a total of 27 patients received bilateral perimodiolar electrode arrays at our institution. The insertion depth angle was estimated on the initial postoperative scans and compared with the insertion depth angle of the postoperative scans performed after contralateral cochlear implantation. Seven (25.93%) patients were found to have an electrode array migration of more than 15°. Electrode migration in perimodiolar electrodes seems to be less frequent and to occur to a lower extent than in lateral wall electrodes. Electrode migration was clinically asymptomatic in all cases.

scholarly journals Restoration of High Frequency Auditory Perception After Robot-Assisted or Manual Cochlear Implantation in Profoundly Deaf Adults Improves Speech Recognition

2021 ◽  
Vol 8 ◽  
Author(s):  
Renato Torres ◽  
Hannah Daoudi ◽  
Ghizlene Lahlou ◽  
Olivier Sterkers ◽  
Evelyne Ferrary ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implantation ◽  
High Frequency ◽  
Pure Tone ◽  
Free Field ◽  
Electrode Array ◽  
Electrode Arrays ◽  
Robot Assisted ◽  
Deaf Adults ◽  
Post Implantation

Background and Purpose: Robot-assisted cochlear implantation has recently been implemented in clinical practice; however, its effect on hearing outcomes is unknown. The aim of this preliminary study was to evaluate hearing performance 1 year post-implantation whether the electrode array was inserted manually or assisted by a robot.Methods: Forty-two profoundly deaf adults were implanted either manually (n = 21) or assisted by a robot (RobOtol®, Collin, Bagneux, France) with three different electrode array types. Participants were paired by age, and electrode array type. The scalar position of the electrode array in the cochlea was assessed by 3D reconstruction from the pre- and post-implantation computed tomography. Pure-tone audiometry and speech perception in silence (percentage of disyllabic words at 60 dB) were tested on the implanted ear 1 year post-implantation in free-field conditions. The pure-tone average was calculated at 250–500–750 Hz, 500–1,000–2,000–3,000 Hz, and 3,000–4,000–8,000 Hz for low, mid, and high frequencies, respectively.Results: One year after cochlear implantation, restoration of the high-frequency thresholds was associated with better speech perception in silence, but not with low or mid frequencies (p < 0.0001; Adjusted R2 = 0.64, polynomial non-linear regression). Although array translocation was similar using either technique, the number of translocated electrodes was lower when the electrode arrays had been inserted with the assistance of the robot compared with manual insertion (p = 0.018; Fisher's exact test).Conclusion: The restoration of high-frequency thresholds (3,000–4,000–8,000 Hz) by cochlear implantation was associated with good speech perception in silence. The numbers of translocated electrodes were reduced after a robot-assisted insertion.

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