Characteristics of Medial and Lateral Wall Cochlear Implant Arrays Demonstrated with Cone Beam CT and Evoked Electrical Auditory Brainstem Responses

被引:0
作者
Alnafjan, Fadwa [1 ,2 ]
da Cruz, Melville J. [2 ,3 ,4 ]
Mcmahon, Catherine M. [1 ]
机构
[1] Macquarie Univ, 16 Univ Ave, Sydney, NSW 2109, Australia
[2] Nextsense Cochlear Implant Program, Sydney, Australia
[3] Westmead Hosp, Sydney, Australia
[4] Univ Sydney, Sydney, Australia
基金
英国惠康基金; 美国国家卫生研究院;
关键词
Array design; Cochlear implants; Cone beam CT; Evoked electrical auditory brainstem responses; ELECTRODE POSITION; PSYCHOPHYSICAL MEASURES; SPEECH-PERCEPTION; IMPEDANCE CHANGES; PREDICTIVE-VALUE; PERIMODIOLAR; STRAIGHT; CONTOUR(TM); THRESHOLD; LOCATION;
D O I
10.1097/MAO.0000000000004431
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Hypothesis This study investigates how electrode array types-straight versus perimodiolar-affect cochlear implant (CI) placement (i.e., modiolar proximity and angular depth) and outcomes using cone beam computed tomography (CBCT) and evoked electrical auditory brainstem responses (eABR). Background Cochlear implants (CIs) have revolutionized auditory rehabilitation, yet optimizing electrode placement remains crucial for improving speech perception and pitch discrimination. Array designs influence electrode proximity to neural structures, impacting neural stimulation efficacy. Methods We analyzed 108 patients using CBCT to compare straight and perimodiolar electrode arrays (each with 22 electrodes) in terms of angular depth, spiral diameter, intracochlear positioning index (ICPI), electrode to modiolus, medial-lateral distance (EMML), and wrapping factor. A subset of 50 patients underwent eABR assessments across cochlear regions. Results Significant differences were found between array types. Straight arrays showed less variability with consistent lateral placement compared to perimodiolar arrays. Measurements revealed differences: wrapping factor (M = 0.692 vs. 0.826; t(11) = 8.104, p = 0.000), angular depth (M = 351.2 degrees vs. 437 degrees; t(11)=4.527, p = 0.000), spiral diameter (M = 3.24 mm vs. 5.027 mm; t(11)=11.1, p = 0.000), and modified ICPI (M = 0.628 vs. 0.783; t(11)=9.742, p = 0.000). eABR results showed larger average amplitudes with straight arrays in basal and mid regions (p < 0.05), suggesting potentially enhanced neural stimulation and a more focused stimulation with perimodiolar arrays. Conclusion Our findings underscore the importance of electrode array type in CI outcomes, emphasizing the need for precise positioning to optimize neural stimulation and clinical outcomes. Personalized array selection based on CBCT assessments may lead to improved speech perception, pitch discrimination, and overall auditory function. Future research should aim to refine stimulation strategies to maximize CI benefits, particularly where direct measurements strongly correlate with clinical outcomes compared to derived measurements.
引用
收藏
页码:364 / 371
页数:8
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