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. 2025 Apr;282(4):1853-1863.
doi: 10.1007/s00405-024-09086-x. Epub 2024 Dec 17.

Influence of cochlear coverage on speech perception in single sided deafness, bimodal, and bilateral implanted cochlear implant patients

Jennifer L Spiegel  1 , Joachim Mueller  2 , Rebecca Boehnlein  2 , John-Martin Hempel  2 , Judith E Spiro  3 , Bernhard G Weiss  2 , Mattis Bertlich  2 , Martin Canis  2 , Tobias Rader  2
Affiliations

Influence of cochlear coverage on speech perception in single sided deafness, bimodal, and bilateral implanted cochlear implant patients

Jennifer L Spiegel et al. Eur Arch Otorhinolaryngol. 2025 Apr.

Abstract

Purpose: Individualized cochlear implantation (CI) is essential to facilitate optimal hearing results for patients. Influence of cochlear coverage (CC) has been studied, however without consideration of different CI-categories, like single sided deafness (SSD), bimodal, and bilateral separately.

Methods: Retrospective analysis of preoperative CT scans was performed at a tertiary center. For each patient their individual CC with the selected electrode array was calculated off the complete CDL. Patients were categorized into SSD (n = 30), bimodal (n = 72), and bilateral CI patients (n = 29). Speech perception within the first 12 months post-implantation was compared between patient groups with shorter and longer CC. For subgroup analysis the cutoff between a shorter or longer CC was identified by the median.

Results: Cutoff between a shorter or longer CC was identified at 65% off the complete CDL for SSD and bimodal patients, and at 70% for bilateral patients. In SSD-patients longer CC was associated with better performance at activation (CCshorter 20.0 ± 28.9% vs. CClonger 31.5 ± 24.7%; p = 0.04) and no benefit was found with deeper insertion at 12 months. No significant benefit was found for deeper insertion in bimodal and bilateral patients.

Conclusions: Capacities of hearing performance seem to differ between SSD, bimodal and bilateral patients within the first year after implantation with regards to cochlear coverage. SSD-patients appear to benefit from deeper insertion than 65% up to 12 months after implantation. However, these results should be interpreted with caution, hence development of speech perception with CI is influenced by a whole range of factors, and bimodal and bilateral treated patients are extremely heterogenous patient groups.

Keywords: Bimodal; Cochlear coverage; SSD; Single sided deafness; Speech perception.

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Conflict of interest statement

Declarations. Conflict of interest: TR and JLS received travel expenses from MED EL GmbH, Innsbruck, Austria and Cochlear Deutschland GmbH & Co. KG. Ethical approval: Study protocol was performed according to ethical guidelines of the 2002 Declaration of Helsinki, and carried out after approval by the Institutional Review Board and Ethics Committee of the Ludwig-Maximilians-Universität München, Munich, Germany (Ethikkommission der LMU München) (reference number 19-562). Consent to participate: Not applicable. Consent for publication (include appropriate statements): Not applicable. Consolidated standard of reporting trial statement: Patient flow diagram see Fig. 1.

Figures

Fig. 1
Fig. 1
Consolidated Standard Reporting of Trials (CONSORT) Flow Diagram
Fig. 2
Fig. 2
Distribution of Cochlear Coverage (CC) for the Patient Groups Single Sided Deafness (SSD), Bimodal, and Bilateral
Fig. 3
Fig. 3
Speech Perception with Freiburg Monosyllabic Test with respect to the Cochlear Coverage for the Different Groups. For subgroup analysis the median cochlear coverage was identified at 65% for SSD and bimodal hearing patients, at 70% for bilateral patients. Data at first fitting (FF), 1 month (1 M), 3 months (3 M), and 12 months (12 M) are depicted in boxplots at the x-axis, the y-axis represents the correct identified monosyllables in percent of the German language Freiburg Monosyllabic Test [–41]. White boxplots resemble shorter CC, green boxplots longer CC. Outliner values are depicted as small circles. A Shows results for SSD patients, B for bimodal, and C for bilateral. *, significant p-value (p < 0.05)
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