scholarly journals Angular Electrode Insertion Depth and Speech Perception in Adults With a Cochlear Implant

2019 ◽  
Vol 40 (7) ◽  
pp. 900-910 ◽  
Author(s):  
Floris Heutink ◽  
Simone R. de Rijk ◽  
Berit M. Verbist ◽  
Wendy J. Huinck ◽  
Emmanuel A. M. Mylanus
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Insertion Depth ◽  
Electrode Insertion

Evaluating Intracochlear Trauma after Cochlear Implant Electrode Insertion through Middle Fossa Approach in Temporal Bones

2017 ◽  
Vol 158 (2) ◽  
pp. 350-357 ◽  
Author(s):  
Juan Carlos Cisneros Lesser ◽  
Rubens de Brito ◽  
Graziela de Souza Queiroz Martins ◽  
Eloisa Maria Mello Santiago Gebrim ◽  
Ricardo Ferreira Bento
Keyword(s):  
Cochlear Implant ◽  
Round Window ◽  
Middle Cranial Fossa ◽  
Middle Fossa ◽  
Insertion Depth ◽  
Middle Fossa Approach ◽  
Basal Turn ◽  
Fresh Frozen ◽  
Electrode Insertion ◽  
Temporal Bones

Objective To evaluate cochlear trauma after cochlear implant insertion through a middle fossa approach by means of histologic and imaging studies in temporal bones. Study Design Prospective cadaveric study. Setting University-based temporal bone laboratory. Subjects and Methods Twenty fresh-frozen temporal bones were implanted through a middle cranial fossa basal turn cochleostomy. Ten received a straight electrode and 10 a perimodiolar electrode. Samples were fixed in epoxy resin. Computed tomography (CT) scans determined direction, depth of insertion, and the cochleostomy to round window distance. The samples were polished by a microgrinding technique and microscopically visualized to evaluate intracochlear trauma. Descriptive and analytic statistics were performed to compare both groups. Results The CT scan showed intracochlear insertions in every bone, 10 directed to the middle/apical turn and 10 to the basal turn. In the straight electrode group, the average number of inserted electrodes was 12.3 vs 15.1 for the perimodiolar group ( U = 78, P = .0001). The median insertion depth was larger for the perimodiolar group (14.4 mm vs 12.5 mm, U = 66, P = .021). Only 1 nontraumatic insertion was achieved and 14 samples (70%) had important trauma (Eshraghi grades 3 and 4). No differences were identified comparing position or trauma grades for the 2 electrode models or when comparing trauma depending on the direction of insertion. Conclusion The surgical technique allows a proper intracochlear insertion, but it does not guarantee a correct scala tympani position and carries the risk of important trauma to cochlear microstructures.

scholarly journals Relationship Between Electrocochleography, Angular Insertion Depth, and Cochlear Implant Speech Perception Outcomes

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael W. Canfarotta ◽  
Brendan P. O’Connell ◽  
Christopher K. Giardina ◽  
Emily Buss ◽  
Kevin D. Brown ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Insertion Depth

Effects of Insertion Depth of Cochlear Implant Electrodes upon Speech Perception

2004 ◽  
Vol 9 (3) ◽  
pp. 163-172 ◽  
Author(s):  
Kumiko Yukawa ◽  
Lawrence Cohen ◽  
Peter Blamey ◽  
Brian Pyman ◽  
Viruch Tungvachirakul ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Insertion Depth

scholarly journals Prediction of the Cochlear Implant Electrode Insertion Depth: Clinical Applicability of two Analytical Cochlear Models

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
G. Mertens ◽  
V. Van Rompaey ◽  
P. Van de Heyning ◽  
E. Gorris ◽  
V. Topsakal
Keyword(s):  
Cochlear Implant ◽  
Insertion Depth ◽  
Clinical Applicability ◽  
Electrode Insertion

The “pull-back” technique for Nucleus 24 perimodiolar electrode insertion

2005 ◽  
Vol 132 (5) ◽  
pp. 751-754 ◽  
Author(s):  
Ingo Todt ◽  
Dietmar Basta ◽  
Andreas Eisenschenk ◽  
Arne Ernst
Keyword(s):  
Cochlear Implant ◽  
Compound Action Potential ◽  
Insertion Depth ◽  
X Ray ◽  
Tertiary Referral Center ◽  
Neural Response Telemetry ◽  
Electrophysiological Recordings ◽  
Spread Of Excitation ◽  
Electrode Insertion ◽  
Nucleus 24

OBJECTIVE: To observe the influence of electrode pull-back after cochlear implant insertion of Nucleus 24 perimodiolar electrodes. STUDY DESIGN: In a prospective intraoperative study, we analyzed the impedances, neural response telemetry responses, and the spread of excitation after cochlear implant electrode insertion and compared these data to those obtained after a subsequent, controlled pull-back of the electrode. Postoperative depth of electrode insertion was controlled by x-ray. SETTING: Tertiary referral center. SUBJECTS: Six patients (4 male, 2 female; 18 to 69 years) were implanted with a Nucleus 24 (RCA) cochlear implant with a perimodiolar electrode. RESULTS: After a controlled pull-back, a significant decrease of the spread of excitation at the stimuli electrodes 5, 10, 15, and a nonsignificant decrease at stimuli electrode 20 compared to the recordings after the primary normal insertion procedure was found. The mean electric compound action potential amplitude was increased with an apical-to-basal tendency. Impedances remained unchanged by the pull-back. Mean insertion depth at the postoperative x-ray control was 372 degrees (± 10.2). CONCLUSION: Controlled cochlear implant electrode pull-back is a novel technique that optimizes objective intraoperative electrophysiological recordings in patients implanted with a Nucleus 24 perimodiolar cochlear implant by a greater approximation of the electrode to the modiolus. (Otolaryngol Head Neck Surg 2005;132:751-4.)

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.

scholarly journals Effects of in vivo repositioning of slim modiolar electrodes on electrical thresholds and speech perception

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang-Yeon Lee ◽  
Young Seok Kim ◽  
Hyung Dong Jo ◽  
Yoonjoong Kim ◽  
Marge Carandang ◽  
...  
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Functional Outcomes ◽  
Cadaveric Study ◽  
Scala Tympani ◽  
Insertion Depth ◽  
Sentence Recognition ◽  
Open Set

AbstractThe slim modiolar electrode has been reported to ensure better modiolar proximity than previous conventional perimodiolar electrodes and consistently high scala tympani localization. Nonetheless, variability in modiolar proximity exists even among slim modiolar electrodes, still leaving room for further improvement of modiolar proximity, which may positively affect functional outcomes. Given this, the pull-back maneuver was reported to increase the modiolar proximity of slim modiolar electrodes in a cadaveric study, but in vivo repositioning effects remain to be established. Here we identified that the pull-back maneuver led to better modiolar proximity than conventional insertion while maintaining a similar angular insertion depth. Notably, the reduced electrode-modiolus distance from the pull-back maneuver was associated with significantly lower impedances across electrodes postoperatively as well as reduced intraoperative electrophysiological thresholds than conventional insertion. Among adult cochlear implant recipients, this maneuver resulted in significantly better sentence recognition scores at three months postoperatively when compared to those with a conventional insertion; however, this benefit was not observed at later intervals. Collectively, slim modiolar electrodes with the pull-back maneuver further enhance the modiolar proximity, possibly leading to better open-set sentence recognition, at least in the early postoperative stage.

The Influence of Cochlear Implant Electrode Position on Performance

2015 ◽  
Vol 20 (3) ◽  
pp. 202-211 ◽  
Author(s):  
Kim S. van der Marel ◽  
Jeroen J. Briaire ◽  
Berit M. Verbist ◽  
Tjeerd J. Muurling ◽  
Johan H.M. Frijns
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Age At Onset ◽  
Performance Outcomes ◽  
Patient Specific ◽  
Electrode Position ◽  
Insertion Depth ◽  
Large Patient ◽  
Large Patient Population

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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