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. 2018 Oct;39(9):1122-1128.
doi: 10.1097/MAO.0000000000001951.

Evaluation of Outcome Variability Associated With Lateral Wall, Mid-scalar, and Perimodiolar Electrode Arrays When Controlling for Preoperative Patient Characteristics

Joshua E Fabie  1 , Robert G Keller, Jonathan L Hatch, Meredith A Holcomb, Elizabeth L Camposeo, Paul R Lambert, Ted A Meyer, Theodore R McRackan
Affiliations

Evaluation of Outcome Variability Associated With Lateral Wall, Mid-scalar, and Perimodiolar Electrode Arrays When Controlling for Preoperative Patient Characteristics

Joshua E Fabie et al. Otol Neurotol. 2018 Oct.

Abstract

Objective: Determine the impact of electrode array selection on audiometric performance when controlling for baseline patient characteristics.

Study design: Retrospective evaluation of a prospective cochlear implant (CI) database (January 1, 2012-May 31, 2017).

Setting: Tertiary Care University Hospital.

Patients: Three hundred twenty-eight adult CI recipients.

Interventions/main outcomes measured: Hearing outcomes were measured through unaided/aided pure tone thresholds and speech recognition testing before and after cochlear implantation. All reported postoperative results were performed at least 6 months after CI activation. All device manufacturers were represented.

Results: Of the 328 patients, 234 received lateral wall (LW) arrays, 46 received perimodiolar (PM) arrays, and 48 received mid-scalar (MS) arrays. Patients receiving PM arrays had significantly poorer preoperative earphone and aided PTAs and SRTs, and aided Consonant-Nucleus-Consonant(CNC) word and AzBio +10 SNR scores compared with patients receiving LW arrays (all p ≤ 0.04), and poorer PTAs and AzBio +10 SNR scores compared with MS recipients (all p ≤ 0.02). No preoperative audiological variables were found to significantly differ between MS and LW patients. After controlling for preoperative residual hearing and speech recognition ability in a hierarchical multiple regression analysis, no statistically significant difference in audiological outcomes was detected (CNC words, AzBio quiet, or AzBio +10 SNR) among the three electrode array types (all p > 0.05).

Conclusion: While previous studies have demonstrated superior postoperative speech recognition scores in LW electrode array recipients, these differences lose significance when controlling for baseline hearing and speech recognition ability. These data demonstrate the proclivity for implanting individuals with greater residual hearing with LW electrodes and its impact on postoperative results.

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Conflict of interest statement

Conflict of Interest Disclosures:

Dr. Holcomb is on the medical advisory board for and has received personal fees from Advanced Bionics and Cochlear Americas and has received grants from Med El Corporation. Dr. Meyer is on the medical advisory board for Advanced Bionics. Dr. Lambert is on the medical advisory board for Cochlear Americas. No other disclosures are reported.

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