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. 2024 Jun 1;45(5):502-506.
doi: 10.1097/MAO.0000000000004165. Epub 2024 Mar 21.

Is the Position of the Basal-Most Electrode Depending on Electrode Array Design and Influencing Postoperative Speech Perception? A Retrospective Analysis of 495 Ears

Rainer Linus Beck  1 , Antje Aschendorff, Susan Arndt, Tanja Hildenbrand, Manuel Christoph Ketterer
Affiliations

Is the Position of the Basal-Most Electrode Depending on Electrode Array Design and Influencing Postoperative Speech Perception? A Retrospective Analysis of 495 Ears

Rainer Linus Beck et al. Otol Neurotol. .

Abstract

Objective: The objective of this study is to examine the influence of electrode array design on the position of the basal-most electrode in cochlear implant (CI) surgery and therefore the stimulability of the basal cochlea. Specifically, we evaluated the angular insertion depth of the basal-most electrode in perimodiolar and straight electrode arrays in relation to postoperative speech perception.

Materials and methods: We conducted a retrospective analysis of 495 patients between 2013 and 2018 using the Cochlear™ Contour Advance® (CA), Cochlear™ Slim Straight® (SSA), or Cochlear™ Slim Modiolar® (SMA) electrode arrays, as well as the MED-EL Flex24 (F24), MED-EL Flex28 (F28), and MED-EL FlexSoft (F31.5) electrode arrays. Cochlear size and the position of the basal-most electrode were measured using rotational tomography or cone beam computed tomography, and the results were compared with postoperative speech perception in monosyllables and numbers.

Results: The straight electrode arrays, specifically the F31.5 (31.5 mm length) and the F28 (28 mm length), exhibited a significantly greater angular insertion depth of the basal-most electrode. No significant correlation was found between cochlear morphology measurements and the position of the basal-most electrode artifact. Cochleostomy-inserted electrode arrays showed a significantly higher insertion depth of the basal-most electrode. Nevertheless, the position of the basal-most electrode did not have a significant impact on postoperative speech perception.

Conclusion: Straight electrode arrays with longer lengths achieved deeper angular insertion depths of the basal-most electrode. Cochlear morphology does not have a substantial influence on the position of basal-most electrode. The study confirms that the basal area of the cochlea, responsible for high-frequency range during acoustic stimulation, is not the primary region for speech understanding via electrical stimulation with CI.

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Conflict of interest statement

Conflict of interest: M.C.K. received travelling expenses and financial support for research from Cochlear Ltd, Australia and financial support for research expenses from Oticon Inc. A.A. received travelling expenses and financial support for research from Cochlear Ltd, Australia; financial support for research and travelling expenses from Med-El, Innsbruck, Austria; financial support for research and travelling expenses from Oticon Inc., Somerset, NJ; financial support for research and travelling expenses from Advanced Bionics, Valencia, CA. S.A. received financial support for research and travelling expenses from Cochlear Ltd, Australia; financial support for research and travelling expenses from Med-El, Innsbruck, Austria travelling expenses from Advanced Bionics, Valencia, CA. The authors R.B. and T.H. declare no conflict of interest. This study is not sponsored by industry.

References

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