Early Hearing Preservation Outcomes Following Cochlear Implantation With New Slim Lateral Wall Electrode Using Electrocochleography

Amit Walia, Matthew A. Shew, Abhinav Ettyreddy, Shannon M. Lefler, Pawina Jiramongkolchai, Cameron C. Wick, Nedim Durakovic, Craig A. Buchman, Jacques A. Herzog

Research output: Contribution to journalArticlepeer-review

Abstract

Objective:Describe early hearing preservation (HP) cochlear implantation (CI) outcomes using a new slim lateral wall electrode (SLWE).Study Design:Prospective cohort study.Setting:Tertiary referral center.Patients:Adult CI candidates with preoperative low-frequency pure-tone average (LFPTA; 125, 250, 500-Hz) ≤60-dB HL.Intervention:CI with and without intracochlear real-time electrocochleography (RT-ECochG).Main Outcome Measure:HP (LFPTA ≤80-dB HL), LFPTA shift, speech-perception performance measures, postoperative CT reconstruction.Results:Forty-two subjects were implanted with the SLWE. Thirty patients underwent full insertion without RT-ECochG feedback, and HP was maintained at 3-months postactivation for 7 (23.3%) patients with mean LFPTA shift of 57.5-±-25.6-dB HL. RT-ECochG feedback was utilized on 12 patients, of whom 6 patients had full insertions and 6 patients had anywhere from 1 to 3 electrodes left outside of the cochlea based on RT-ECochG feedback. At 3 months postoperatively, HP was achieved on 10 (83.3%) patients and mean LFPTA shift was 18.9 c 11.7-dB HL. Mean difference between LFPTA threshold shift at 3-months postactivation with and without RT-ECochG was 38.6-dB HL (95% CI, 25.6-51.67). There was an improvement in delta CNC from preoperative to 3-months postactivation when using RT-ECochG, with mean difference 20.7% (95% CI, 3.3-38.1).Conclusions:Use of RT-ECochG monitoring during SLWE placement results in fewer full electrode insertions and significantly better HP rates and speech-perception outcomes when compared with unmonitored insertions. Further investigation is needed to evaluate long-term audiologic outcomes to better understand the relationships among ECochG, cochlear trauma, functional outcomes, and HP.

Original languageEnglish
Pages (from-to)443-451
Number of pages9
JournalOtology and Neurotology
Volume43
Issue number4
DOIs
StatePublished - Apr 1 2022

Keywords

  • CI624
  • Cochlear implantation
  • Cochlear implants
  • ECochG
  • Electrocochleography
  • Hearing preservation
  • Lateral wall electrode
  • SLWE
  • Slim 20 electrode

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