Analysis of Neural Interface When Using Modiolar Electrode Stimulation. Radiological Evaluation, Trans-Impedance Matrix Analysis and Effect on Listening Effort in Cochlear Implantation

Background: The proximity of the electrode to the modiolar wall may be of interest to investigate the effect of pitch discrimination. This research establishes the relation between these factors and whether perimodiolar positions may provide benefits regarding improved electrode discrimination. Methods: A prospective randomized study including 24 post-lingual deaf adults was performed. A psychoacoustic study was done by using a psychoacoustic research platform. Radiological study, and a cone-beam computed tomography was used to assess post cochlear implantation electrodes’ position. Trans-impedance matrix (TIM) analysis was performed after cochlear implant insertion in all cases, and pupillometry test was also performed. Results: 12 patients received a slim perimodiolar electrode array, and 12 patients received a straight electrode array. Although all the patients showed similar speech test results after 12 months follow-up, those implanted with a perimodiolar electrode obtained better scores in electrode discrimination test and pupillometry test, and showed more homogenous TIM patterns. Conclusions: The better positioning of the electrode array seams to provide a better hearing resolution and less listening effort trans-impedance matrix seems to be a useful tool to analyze positioning of the perimodiolar array.

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Cochlear Implantation in the Elderly: Results and Quality-of-Life Assessment

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940211101005 ◽

2002 ◽

Vol 111 (10) ◽

pp. 890-895 ◽

Cited By ~ 42

Author(s):

Hamid R. Djalilian ◽

Sharon L. Smith ◽

Timothy A. King ◽

Samuel C. Levine

Keyword(s):

Quality Of Life ◽

Complication Rate ◽

Cochlear Implantation ◽

Chart Review ◽

Retrospective Chart Review ◽

The Elderly ◽

Life Assessment ◽

Test Results

To assess the efficacy, quality of life, and complication rate of cochlear implantation in patients over 60 years of age, we performed a retrospective chart review of 31 cochlear implant patients more than 60 years old at the time of surgery (mean, 70 years; range, 62 to 86 years). All patients had improvement in their audiological test results after operation. Twenty-eight patients (93%) are regular implant users at a median follow-up of 12 months. Major complications occurred in 2 patients (6%). We conclude that cochlear implantation in the elderly population has excellent results, with a complication rate similar to that in patients less than 60 years old, and yields an improved quality of life.

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Cochlear Implants in Single-Sided Deafness. Comparison Between Children and Adult Populations With Post-lingually Acquired Severe to Profound Hearing Loss

Frontiers in Neurology ◽

10.3389/fneur.2021.760831 ◽

2021 ◽

Vol 12 ◽

Author(s):

Nadia Falcón Benítez ◽

Juan Carlos Falcón González ◽

Ángel Ramos Macías ◽

Silvia Borkoski Barreiro ◽

Ángel Ramos de Miguel

Keyword(s):

Hearing Loss ◽

Speech Perception ◽

Cochlear Implantation ◽

Speech Test ◽

Deaf Adults ◽

Common Etiology ◽

Single Sided Deafness ◽

Positive Results ◽

Auditory Lateralization

Objective: To determine audiological and clinical results of cochlear implantation (CI) comparing two populations with single-sided deafness (SSD): post-lingually deaf children between 6 and 12 years of age, and post-lingually deaf adults, in order to evaluate the effect of CI in different age groups.Design: Retrospective case review.Setting: Tertiary clinic.Patients and Method: Twenty-three children and twenty-one adult patients that were candidates for CI with single-side deafness were included. In all cases we evaluate: Speech perception thresholds; disyllabic words test (65 dB SPL) were performed in the modalities S0–SCI–SNH and Auditory Lateralization Test. The Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaire was also used. All results were obtained after 12 months of CI activation.Results: In children, the most common etiology was idiopathic sensory-neural hearing loss. They showed positive results in the Auditory Lateralization Test. In the Speech Test, word recognition in noise improved from 2% preoperatively to 61.1% at a mean follow-up of 1 year (S0 condition) in children [test with signal in CI side 60% and signal normal hearing side (plugged) 31%]. The processor was used for >12 h in all cases. With respect to the SSQ questionnaire, parents were more satisfied within the postoperative period than within the preoperative period. For adults, the most common etiology was idiopathic sudden sensorineural hearing loss (SNHL). Positive results in the Auditory Lateralization Test were found. With respect to the Speech Test in quiet conditions: Word recognition in noise improved from 5.7% preoperatively to 71.8% at a mean follow-up of 1 year [test with signal in CI side 68% and signal normal hearing side (plugged) 41%]. The processor was used for >12 h. In the SSQ questionnaire, the post-operative results showed a beneficial effect of the CI. No adverse events were reported during the study period. No differences were found between children and adults in all tests in this study.Conclusions: Cochlear implantation in post-lingually deaf adults and children with SSD can achieve a speech perception outcome comparable with CI in conventional candidates. Improvements in spatial hearing were also observed. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.

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Cochlear implantation and quality of life in postlingually deaf adults: Long-term follow-up

Otolaryngology ◽

10.1016/j.otohns.2006.11.044 ◽

2007 ◽

Vol 136 (4) ◽

pp. 597-604 ◽

Cited By ~ 73

Author(s):

Godelieve W.J.A. Damen ◽

Andy J. Beynon ◽

Paul F.M. Krabbe ◽

Jef J.S. Mulder ◽

Emmanuel A.M. Mylanus

Keyword(s):

Quality Of Life ◽

Cochlear Implantation ◽

Deaf Adults ◽

Long Term Follow Up

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Cochlear implantation and quality of life in postlingually deaf adults: Long-term follow-up

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/s1041-892x(08)79271-0 ◽

2008 ◽

Vol 2008 ◽

pp. 69

Author(s):

B.J. Balough

Keyword(s):

Quality Of Life ◽

Cochlear Implantation ◽

Deaf Adults ◽

Long Term Follow Up

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Single stage cochlear implantation in radical mastoid cavity- a surgical dilemma

Journal of Otolaryngology-ENT Research ◽

10.15406/joentr.2020.12.00464 ◽

2020 ◽

Vol 12 (3) ◽

pp. 102-106

Author(s):

Naresh K Panda ◽

Gyanaranjan Nayak ◽

Roshan Verma

Keyword(s):

Cochlear Implantation ◽

Electrode Array ◽

Complete Removal ◽

Single Stage ◽

Mastoid Cavity ◽

Epithelial Lining ◽

Blind Sac Closure ◽

Cavity Obliteration ◽

Temporoparietal Fascia Flap

Objective: To describe the potential problems of cochlear implantation in mastoid cavity with possibilities of extrusion of electrode array by breakdown of epithelial lining or flap cover recurrent cholesteatoma and spread of infection to the implant. The issues with surgical management and subsequent follow up is discussed. Methods: In a Series of 170 Cochlear Implantations at our centre, four patients had Cochlear Implantation with Blind sac closure, complete removal of epithelium from the radical mastoid cavity, obliteration of the cavity with temporoparietal fascia flap and electrode insertion. Follow up ranging from 21 months up to 84 months is available. One patient during follow up had to undergo re implantation due to extrusion of the electrodes. Results: All the patients had good outcome regarding hearing improvement. One of the patients had to undergo exploration and re implantation of electrodes due to extrusion of electrodes through the external auditory canal. This patient had a canal cholesteatoma. Discussion: An important issue in single stage procedure is ensuring complete removal of fibro epithelial lining of the cavity. The advantage is cost reduction and minimizes the need for multiple general anesthesia. A follow up CT scan at regular intervals is required to detect recurrence. Conclusions: The patients undergoing cochlear implantation in a radical mastoid cavity require intensive follow up with computerized tomography to detect recidivism, Single stage cochlear implantation in radical mastoid cavity is an appropriate therapeutic decision by the cochlear implant surgeon.

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Hearing Preservation with the Slim Modiolar Electrode Nucleus CI532® Cochlear Implant: A Preliminary Experience

Audiology and Neurotology ◽

10.1159/000486409 ◽

2017 ◽

Vol 22 (6) ◽

pp. 317-325 ◽

Cited By ~ 13

Author(s):

Angel Ramos-Macías ◽

S.A. Borkoski-Barreiro ◽

J.C. Falcón-González ◽

A. Ramos-de Miguel

Keyword(s):

Cochlear Implant ◽

Randomized Study ◽

Electrode Array ◽

Hearing Preservation ◽

Residual Hearing ◽

Flexible Electrode ◽

And Performance ◽

The Impact ◽

Sydney Australia

As the indications for cochlear implant have expanded to include younger patients and individuals with greater degrees of residual hearing, increasing emphasis has been placed on atraumatic surgery and the preservation of the cochlear structure. Here, a descriptive prospective randomized study was performed. It was shown that residual hearing preservation is possible 12 months postoperatively with an atraumatic perimodiolar flexible electrode array CI532® (Cochlear Ltd, Sydney, Australia). Residual hearing preservation, considered as < 15 dB, was obtained in 70% of the cases. Better clinical outcomes and performance could be obtained compared with the previous perimodiolar CI512®, but further research and a longer follow-up are necessary to verify the impact of outcomes.

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

Frontiers in Surgery ◽

10.3389/fsurg.2021.729736 ◽

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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