TY - JOUR
T1 - Early Hearing Preservation Outcomes Following Cochlear Implantation With New Slim Lateral Wall Electrode Using Electrocochleography
AU - Walia, Amit
AU - Shew, Matthew A.
AU - Ettyreddy, Abhinav
AU - Lefler, Shannon M.
AU - Jiramongkolchai, Pawina
AU - Wick, Cameron C.
AU - Durakovic, Nedim
AU - Buchman, Craig A.
AU - Herzog, Jacques A.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - 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.
AB - 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.
KW - CI624
KW - Cochlear implantation
KW - Cochlear implants
KW - ECochG
KW - Electrocochleography
KW - Hearing preservation
KW - Lateral wall electrode
KW - SLWE
KW - Slim 20 electrode
UR - http://www.scopus.com/inward/record.url?scp=85126490274&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000003475
DO - 10.1097/MAO.0000000000003475
M3 - Article
C2 - 35170555
AN - SCOPUS:85126490274
SN - 1531-7129
VL - 43
SP - 443
EP - 451
JO - Otology and Neurotology
JF - Otology and Neurotology
IS - 4
ER -