Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array.

OBJECTIVE To describe outcomes from cochlear implantation with a new, slim modiolar electrode array. STUDY DESIGN Retrospective cohort study. SETTING Tertiary referral centers. PATIENTS Adult cochlear implant candidates. INTERVENTIONS Cochlear implantation with CI532 (Cochlear Corp). MAIN OUTCOME MEASURES Pre- and postoperative speech perception scores, operative details, and postoperative computed tomography (CT) reconstructions of array location. RESULTS One hundred seventeen patients are implanted to date. There were eight tip rollovers identified with intraoperative x-ray and resolved with reinsertion. An additional rollover was identified on postoperative CT. CT reconstructions in 17 of 23 patients showed complete scala tympani placement with a wrap factor of 58% (range 53-64%) and a mean insertion angle of 406 degrees (range 360-452 degrees). Three implants demonstrated array translocation with electrodes in the scala vestibuli. Consonant-nucleus-consonant word scores improved from 10% preoperatively to 48% at 3 months postoperatively. Pure-tone thresholds were preserved postoperatively in 37 to 52% of patients across frequencies from 250 to 4000 Hz. Functional pure-tone thresholds (≤80 dB) were recorded in 9 to 25% of patients. CONCLUSION CI532 array insertion results in consistent scala tympani location and provides expected audiologic performance. Initial hearing preservation results are not consistent with current electro-acoustic arrays.

[1]  Benoit M Dawant,et al.  Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes , 2014, The Laryngoscope.

[2]  English R. King,et al.  Hearing preservation and speech perception outcomes with electric‐acoustic stimulation after 12 months of listening experience , 2013, The Laryngoscope.

[3]  J. Firszt,et al.  Factors Affecting Outcomes in Cochlear Implant Recipients Implanted With a Perimodiolar Electrode Array Located in Scala Tympani , 2016, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[4]  Benoit M Dawant,et al.  Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation , 2016, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[5]  Hugh J. McDermott,et al.  Factors Predicting Postoperative Unilateral and Bilateral Speech Recognition in Adult Cochlear Implant Recipients with Acoustic Hearing , 2016, Ear and hearing.

[6]  W. Parkinson,et al.  Residual speech recognition and cochlear implant performance: effects of implantation criteria. , 1999, The American journal of otology.

[7]  S. Waltzman,et al.  An Evidence-Based Algorithm for Intraoperative Monitoring During Cochlear Implantation , 2012, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[8]  Bart Carelsen,et al.  Spread of Excitation Measurements for the Detection of Electrode Array Foldovers: A Prospective Study Comparing 3-Dimensional Rotational X-ray and Intraoperative Spread of Excitation Measurements , 2009, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[9]  Joseph Roberson,et al.  Nucleus Freedom North American Clinical Trial , 2007, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[10]  A. Beynon,et al.  Factors Affecting Auditory Performance of Postlinguistically Deaf Adults Using Cochlear Implants: An Update with 2251 Patients , 2012, Audiology and Neurotology.

[11]  T. Hullar,et al.  Verification of Computed Tomographic Estimates of Cochlear Implant Array Position: A Micro-CT and Histologic Analysis , 2011, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[12]  Margaret W Skinner,et al.  Role of Electrode Placement as a Contributor to Variability in Cochlear Implant Outcomes , 2008, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[13]  Karen M Mispagel,et al.  Factors Affecting Open-Set Word Recognition in Adults With Cochlear Implants , 2013, Ear and hearing.

[14]  Thomas Lenarz,et al.  Study of "障碍" , 2011 .

[15]  Thomas Klenzner,et al.  Quality Control After Insertion of the Nucleus Contour and Contour Advance Electrode in Adults , 2007, Ear and hearing.

[16]  A. Beynon,et al.  Pre-, Per- and Postoperative Factors Affecting Performance of Postlinguistically Deaf Adults Using Cochlear Implants: A New Conceptual Model over Time , 2012, PloS one.

[17]  J. Oleson,et al.  Hybrid 10 Clinical Trial , 2009, Audiology and Neurotology.

[18]  René H. Gifford,et al.  Speech Recognition Materials and Ceiling Effects: Considerations for Cochlear Implant Programs , 2008, Audiology and Neurotology.

[19]  K. Green,et al.  Predictors of audiological outcome following cochlear implantation in adults , 2007, Cochlear implants international.

[20]  René H. Gifford,et al.  Evidence for the Expansion of Adult Cochlear Implant Candidacy , 2010, Ear and hearing.