Comparison of Perimodiolar Electrodes: Imaging and Electrophysiological Outcomes.
Journal
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
entrez:
14
7
2020
pubmed:
14
7
2020
medline:
15
4
2021
Statut:
ppublish
Résumé
The perimodiolar CI532 Slim Modiolar electrode has been designed to bring the electrode contacts close to auditory nerve while reducing cochlear trauma during its insertion. It is currently unknown to what extent the electrode position and electrophysiological outcomes of the Slim Modiolar electrode differ from other perimodiolar electrodes. The objective was to compare the electrode position and electrophysiological outcomes between the CI532 Slim Modiolar and CI512 Contour Advance electrode. Forty-six adult patients received a Slim Modiolar or Contour Advance electrode. Electrode types were compared using intraoperative electrode impedances, evoked compound action potential (ECAP) and stapedius reflex thresholds, as well as position parameters from postoperative computed tomography or digital volume tomography images (medial-lateral position, electrode-to-modiolus distance, insertion angle). The medial-lateral position indicates a closer modiolar placement of the Slim Modiolar compared with the Contour Advance. Individual electrode contact measurements, however, showed significantly larger electrode-to-modiolus distances and higher ECAP thresholds for the Slim Modiolar in the basal region. On contacts E20-22 the Slim Modiolar is slightly closer to the modiolus compared with the Contour Advance, but this did not result in lower ECAP thresholds. Perimodiolar electrodes can vary in their intracochlear position, leading to divergent electrophysiological outcomes. To detect these differences, investigations must be done for each electrode contact rather than using a global factor for the whole electrode array. While the electrode dislocation rate is lower with the Slim Modiolar than with the Contour Advance, electrode-to-modiolus proximity is smaller and ECAP thresholds are lower with the Contour Advance in the basal cochlear region.
Sections du résumé
BACKGROUND
The perimodiolar CI532 Slim Modiolar electrode has been designed to bring the electrode contacts close to auditory nerve while reducing cochlear trauma during its insertion. It is currently unknown to what extent the electrode position and electrophysiological outcomes of the Slim Modiolar electrode differ from other perimodiolar electrodes.
OBJECTIVES
The objective was to compare the electrode position and electrophysiological outcomes between the CI532 Slim Modiolar and CI512 Contour Advance electrode.
METHOD
Forty-six adult patients received a Slim Modiolar or Contour Advance electrode. Electrode types were compared using intraoperative electrode impedances, evoked compound action potential (ECAP) and stapedius reflex thresholds, as well as position parameters from postoperative computed tomography or digital volume tomography images (medial-lateral position, electrode-to-modiolus distance, insertion angle).
RESULTS
The medial-lateral position indicates a closer modiolar placement of the Slim Modiolar compared with the Contour Advance. Individual electrode contact measurements, however, showed significantly larger electrode-to-modiolus distances and higher ECAP thresholds for the Slim Modiolar in the basal region. On contacts E20-22 the Slim Modiolar is slightly closer to the modiolus compared with the Contour Advance, but this did not result in lower ECAP thresholds.
CONCLUSIONS
Perimodiolar electrodes can vary in their intracochlear position, leading to divergent electrophysiological outcomes. To detect these differences, investigations must be done for each electrode contact rather than using a global factor for the whole electrode array. While the electrode dislocation rate is lower with the Slim Modiolar than with the Contour Advance, electrode-to-modiolus proximity is smaller and ECAP thresholds are lower with the Contour Advance in the basal cochlear region.
Identifiants
pubmed: 32658111
doi: 10.1097/MAO.0000000000002790
pii: 00129492-202008000-00047
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e934-e944Références
Hassanzadeh S, Farhadi M, Daneshi A, Emamdjomeh H. The effects of age on auditory speech perception development in cochlear-implanted prelingually deaf children. Otolaryngol Head Neck Surg 2002; 126:524–527.
Rubinstein JT, Parkinson WS, Tyler RS, et al. Residual speech recognition and cochlear implant performance: Effects of implantation criteria. Am J Otol 1999; 20:445–452.
Mondain M, Sillon M, Vieu A, et al. Cochlear implantation in prelingually deafened children with residual hearing. Int J Pediatr Otorhinolaryngol 2002; 63:91–97.
Friedland DR, Venick HS, Niparko JK. Choice of ear for cochlear implantation: The effect of history and residual hearing on predicted postoperative performance. Otol Neurotol 2003; 24:582–590.
Hoppe U, Hast A, Hocke T. Audiometry-based screening procedure for cochlear implant candidacy. Otol Neurotol 2015; 36:1001–1005.
Papsin BC, Gysin C, Picton N, Nedzelski J, Harrison RV. Speech perception outcome measures in prelingually deaf children up to four years after cochlear implantation. Ann Otol Rhinol Laryngol Suppl 2000; 185:38–42.
Müller-Deile J. Methods for fitting and evaluation of cochlear implant speech processors. Heidelberg: Median-Verlag von Killisch-Horn GmbH; 2000.
Skinner MW. Optimizing cochlear implant speech performance. Ann Otol Rhinol Laryngol Suppl 2003; 191:4–13.
Hey M, Hocke T, Mauger S, Müller-Deile J. A clinical assessment of cochlear implant recipient performance: Implications for individualized map settings in specific environments. Eur Arch Otorhinolaryngol 2016; 273:4011–4020.
Shepherd RK, Hatsushika S, Clark GM. Electrical stimulation of the auditory nerve: The effect of electrode position on neural excitation. Hear Res 1993; 66:108–120.
van Wermeskerken GK, van Olphen AF, Graamans L. Imaging of electrode position in relation to electrode functioning after cochlear implantation. Eur Arch Otorhinolaryngol 2009; 266:1527–1531.
Davis TJ, Zhang D, Gifford RH, Noble JH. Relationship between electrode-to-modiolus distance and current levels for adults with cochlear implants. Otol Neurotol 2016; 37:31–37.
Long CJ, Holden TA, McClelland GH, et al. Examining the electro-neural interface of cochlear implant users using psychophysics, CT scans, and speech understanding. J Assoc Res Otolaryngol 2014; 15:293–304.
Poley M, Overmyera E, Crauna P, et al. Does pediatric cochlear implant insertion technique affect intraoperative neural response telemetry thresholds? Int J Pediatr Otorhinolaryngol 2015; 79:1404–1407.
Cohen LT, Richardson LM, Saunders E, Cowan RS. Spatial spread of neural excitation in cochlear implant recipients: Comparison of improved ECAP method and psychophysical forward masking. Hear Res 2003; 179:72–87.
Hughes ML, Abbas PJ. Electrophysiologic channel interaction, electrode pitch ranking, and behavioral threshold in straight versus perimodiolar cochlear implant electrode arrays. J Acoust Soc Am 2006; 119:1538–1547.
Runge-Samuelson C, Firszt JB, Gaggl W, Wackym PA. Electrically evoked auditory brainstem responses in adults and children: Effects of lateral to medial placement of the Nucleus 24 Contour electrode array. Otol Neurotol 2009; 30:464–470.
Aschendorff A, Kubalek R, Turowski B, et al. Quality control after cochlear implant surgery by means of rotational tomography. Otol Neurotol 2005; 26:34–37.
Aschendorff A, Kromeier J, Klenzner T, Laszig T. Quality control after insertion of the Nucleus Contour and Contour Advance electrode in adults. Ear Hear 2007; 28:75S–79S.
Aschendorff A, Briggs R, Brademann G, et al. Clinical investigation of the Nucleus Slim Modiolar Electrode. Audiol Neurootol 2017; 22:169–179.
Hey M, Wesarg T, Mewes A, et al. Objective, audiological and quality of life measures with the CI532 slim modiolar electrode. Cochlear Implants Int 2019; 22:1–11.
Shaul C, Dragovic AS, Stringer AK, et al. Scala localisation of peri-modiolar electrodes and speech perception outcomes. J Laryngol Otol 2018; 132:1000–1006.
Riemann C, Sudhoff H, Todt I. The pull-back technique for the 532 slim modiolar electrode. Biomed Res Int 2019; 2019:6917084.
Cohen LT, Xu J, Xu SA, Clark GM. Improved and simplified methods for specifying positions of the electrode bands of a cochlear implant array. Am J Otol 1996; 17:859–865.
Verbist BM, Skinner MW, Cohen LT, et al. Consensus panel on a cochlear coordinate system applicable in histologic, physiologic, and radiologic studies of the human cochlea. Otol Neurotol 2010; 31:722–730.
Xu J, Xu SA, Cohen LT, Clark GM. Cochlear view: Postoperative radiography for cochlear implantation. Am J Otol 2000; 21:49–56.
Holden LK, Finley CC, Firszt JB, et al. Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear 2013; 34:342–360.
Escudé B, James C, Deguine O, Cochard N, Eter E, Fraysse B. The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurotol 2006; 11: (Suppl 1): 27–33.
Cohen LT, Xu J, Tycocinski M, Saunders E, Raja D, Cowan R. Evaluation of an X-ray analysis method: Comparison of electrode position estimates with information from phase contrast X-ray and histology. Presented at the 5th European Symposium on Paediatric Cochlear Implantation, Antwerp, Belgium, June 4–7 2000.
Brown CJ, Abbas PJ, Gantz B. Electrically evoked whole-nerve action potentials: Data from human cochlear implant users. J Acoust Soc Am 1990; 88:1385–1391.
Cafarelli Dees D, Dillier N, Lai WK, et al. Normative findings of electrically evoked compound action potential measurements using the neural response telemetry of the Nucleus CI24 M cochlear implant system. Audiol Neurootol 2005; 10:105–116.
Dillier N, Lai WK, Almqvist B, et al. Measurement of the electrically evoked compound action potential via a neural response telemetry system. Ann Otol Rhinol Laryngol 2002; 111 (5 pt 1):407–414.
Esquia Medina GN, Borel S, Nguyen Y, et al. Is electrode-modiolus distance a prognostic factor for hearing performance after cochlear implant surgery? Audiol Neurootol 2013; 18:406–413.
Mewes A, Brademann G, Hey M (2019) Elektrophysiologische Kenndaten und Lageparameter zur Qualitätskontrolle bei der CI-Versorgung, in Gromoll C, Wegner N (eds.) 50. Jahrestagung Deutsche Gesellschaft für Medizinische Physik – Abstractband. Deutsche Gesellschaft für Medizinische Physik, Stuttgart, p. 90.
Brademann G, Mewes A, Hey M, Ambrosch P. Influence of the insertion depth of the cochlear implant electrode on the intra-operative electrophysiological results in the treatment with CI532 implants. Laryngorhinootol 2019; 98:S308.
Saunders E, Cohen L, Aschendorff A, et al. Threshold, comfortable level and impedance changes as a function of electrode-modiolar distance. Ear Hear 2002; 23: (1 suppl): 28–40.
Tykocinski M, Cohen LT, Cowan RS. Measurement and analysis of access resistance and polarization impedance in cochlear implant recipients. Otol Neurotol 2005; 26:948–956.
Xu J, Shepherd RK, Millard RE, Clark GM. Chronic electrical stimulation of the auditory nerve at high stimulus rates: A physiological and histopathological study. Hear Res 1997; 105:1–29.
Kawano A, Seldon HL, Clark GM, Ramsden RT, Raine CH. Intracochlear factors contributing to psychophysical percepts following cochlear implantation. Acta Otolaryngol 1998; 118:313–326.
Seyyedi M, Nadol JB Jr. Intracochlear inflammatory response to cochlear implant electrodes in humans. Otol Neurotol 2014; 35:1545–1551.
Ramos-Macías A, Borkoski-Barreiro SA, Falcón-González JC, Ramos-de Miguel A. Hearing preservation with the slim modiolar electrode nucleus ci532® cochlear implant: A preliminary experience. Audiol Neurootol 2017; 22:317–325.
Dorman MF, Smith LM, Dankowski K, McCandless G, Parkin JL. Long-term measures of electrode impedance and auditory thresholds for the Ineraid cochlear implant. J Speech Hear Res 1992; 35:1126–1130.
Paasche G, Bockel F, Tasche C, Lesinski-Schiedat A, Lenarz T. Changes of postoperative impedances in cochlear implant patients: The short-term effects of modified electrode surfaces and intracochlear corticosteroids. Otol Neurotol 2006; 27:639–647.
Newbold C, Mergen S, Richardson R, et al. Impedance changes in chronically implanted and stimulated cochlear implant electrodes. Cochlear Implants Int 2014; 15:191–199.
Botros A, Psarros C. Neural response telemetry reconsidered: I. The relevance of ECAP threshold profiles and scaled profiles to cochlear implant fitting. Ear Hear 2010; 31:367–379.
Müller A, Hocke T, Mir-Salim P. Intraoperative findings on ECAP-measurement: Normal or special case? Int J Audiol 2015; 54:257–267.
McJunkin JL, Durakovic N, Herzog J, et al. Early outcomes with a slim, modiolar cochlear implant electrode array. Otol Neurotol 2018; 39:e28–e33.