Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation

Brendan P. O'Connell, Ahmet Cakir, Jacob B. Hunter, David O. Francis, Jack H. Noble, Robert F. Labadie, Geraldine Zuniga, Benoit M. Dawant, Alejandro Rivas, George B. Wanna

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objectives: 1) Investigate the impact of electrode type and surgical approach on scalar electrode location; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting: Tertiary academic hospital. Patients: Two hundred twenty post-lingually deafened adults undergoing cochlear implant (CI). Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance. Results: In 68% of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar (PM) and mid-scala (MS) electrodes were 22.4 (95% CI: 6.3-80.0, p < 0.001) and 55.0 (95% CI: 9.7-312.8, p < 0.001) times more likely to have at least one electrode in the scala vestibuli (SV) compared with lateral wall (LW) electrodes, respectively. Compared with cochleostomy (C), round window (RW) and extended round window (ERW) approaches demonstrated 70% reduction in SV insertion (RW: OR 0.28, 95% CI: 0.1-0.8, p = 0.01; ERW: OR 0.28, 95% CI: 0.1-0.7, p = 0.005). Examining postoperative audiometric performance, consonant-nucleus-consonant (CNC) score increased 0.6% with every 10 degrees increase in angular insertion depth beyond the group minimum of 208 degrees (coefficient 0.0006, 95% CI: 0.0001-0.001, p = 0.03). SV insertion was associated with a 12% decrease in CNC score (coefficient -0.12, 95% CI: -0.22 to -0.02, p = 0.02). CNC score decreased 0.3% for every 1 year increase in age (coefficient -0.003, 95% CI: -0.006 to -0.0006, p = 0.02). Conclusions: Electrode design and surgical approach were predictors of scalar electrode location. Specifically, LW electrodes showed higher rates of ST insertion compared with PM or MS. RW and ERW approaches showed higher rates of ST insertion when compared with C. In regards to performance, ST insertion, younger age, and greater angular insertion depth were predictors of improved CNC scores.

Original languageEnglish (US)
Pages (from-to)1016-1023
Number of pages8
JournalOtology and Neurotology
Volume37
Issue number8
DOIs
StatePublished - Sep 1 2016

Fingerprint

Cochlear Implantation
Cochlear Implants
Electrodes
Scala Tympani
Scala Vestibuli
Outcome Assessment (Health Care)
Tertiary Care Centers
Multivariate Analysis

Keywords

  • Angular insertion depth
  • Cochlear implant
  • Electrode design
  • Electrode location
  • Scala tympani
  • Scalar translocation
  • Speech perception

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation. / O'Connell, Brendan P.; Cakir, Ahmet; Hunter, Jacob B.; Francis, David O.; Noble, Jack H.; Labadie, Robert F.; Zuniga, Geraldine; Dawant, Benoit M.; Rivas, Alejandro; Wanna, George B.

In: Otology and Neurotology, Vol. 37, No. 8, 01.09.2016, p. 1016-1023.

Research output: Contribution to journalArticle

O'Connell, BP, Cakir, A, Hunter, JB, Francis, DO, Noble, JH, Labadie, RF, Zuniga, G, Dawant, BM, Rivas, A & Wanna, GB 2016, 'Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation', Otology and Neurotology, vol. 37, no. 8, pp. 1016-1023. https://doi.org/10.1097/MAO.0000000000001125
O'Connell, Brendan P. ; Cakir, Ahmet ; Hunter, Jacob B. ; Francis, David O. ; Noble, Jack H. ; Labadie, Robert F. ; Zuniga, Geraldine ; Dawant, Benoit M. ; Rivas, Alejandro ; Wanna, George B. / Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation. In: Otology and Neurotology. 2016 ; Vol. 37, No. 8. pp. 1016-1023.
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abstract = "Objectives: 1) Investigate the impact of electrode type and surgical approach on scalar electrode location; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting: Tertiary academic hospital. Patients: Two hundred twenty post-lingually deafened adults undergoing cochlear implant (CI). Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance. Results: In 68{\%} of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar (PM) and mid-scala (MS) electrodes were 22.4 (95{\%} CI: 6.3-80.0, p < 0.001) and 55.0 (95{\%} CI: 9.7-312.8, p < 0.001) times more likely to have at least one electrode in the scala vestibuli (SV) compared with lateral wall (LW) electrodes, respectively. Compared with cochleostomy (C), round window (RW) and extended round window (ERW) approaches demonstrated 70{\%} reduction in SV insertion (RW: OR 0.28, 95{\%} CI: 0.1-0.8, p = 0.01; ERW: OR 0.28, 95{\%} CI: 0.1-0.7, p = 0.005). Examining postoperative audiometric performance, consonant-nucleus-consonant (CNC) score increased 0.6{\%} with every 10 degrees increase in angular insertion depth beyond the group minimum of 208 degrees (coefficient 0.0006, 95{\%} CI: 0.0001-0.001, p = 0.03). SV insertion was associated with a 12{\%} decrease in CNC score (coefficient -0.12, 95{\%} CI: -0.22 to -0.02, p = 0.02). CNC score decreased 0.3{\%} for every 1 year increase in age (coefficient -0.003, 95{\%} CI: -0.006 to -0.0006, p = 0.02). Conclusions: Electrode design and surgical approach were predictors of scalar electrode location. Specifically, LW electrodes showed higher rates of ST insertion compared with PM or MS. RW and ERW approaches showed higher rates of ST insertion when compared with C. In regards to performance, ST insertion, younger age, and greater angular insertion depth were predictors of improved CNC scores.",
keywords = "Angular insertion depth, Cochlear implant, Electrode design, Electrode location, Scala tympani, Scalar translocation, Speech perception",
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T1 - Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation

AU - O'Connell, Brendan P.

AU - Cakir, Ahmet

AU - Hunter, Jacob B.

AU - Francis, David O.

AU - Noble, Jack H.

AU - Labadie, Robert F.

AU - Zuniga, Geraldine

AU - Dawant, Benoit M.

AU - Rivas, Alejandro

AU - Wanna, George B.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objectives: 1) Investigate the impact of electrode type and surgical approach on scalar electrode location; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting: Tertiary academic hospital. Patients: Two hundred twenty post-lingually deafened adults undergoing cochlear implant (CI). Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance. Results: In 68% of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar (PM) and mid-scala (MS) electrodes were 22.4 (95% CI: 6.3-80.0, p < 0.001) and 55.0 (95% CI: 9.7-312.8, p < 0.001) times more likely to have at least one electrode in the scala vestibuli (SV) compared with lateral wall (LW) electrodes, respectively. Compared with cochleostomy (C), round window (RW) and extended round window (ERW) approaches demonstrated 70% reduction in SV insertion (RW: OR 0.28, 95% CI: 0.1-0.8, p = 0.01; ERW: OR 0.28, 95% CI: 0.1-0.7, p = 0.005). Examining postoperative audiometric performance, consonant-nucleus-consonant (CNC) score increased 0.6% with every 10 degrees increase in angular insertion depth beyond the group minimum of 208 degrees (coefficient 0.0006, 95% CI: 0.0001-0.001, p = 0.03). SV insertion was associated with a 12% decrease in CNC score (coefficient -0.12, 95% CI: -0.22 to -0.02, p = 0.02). CNC score decreased 0.3% for every 1 year increase in age (coefficient -0.003, 95% CI: -0.006 to -0.0006, p = 0.02). Conclusions: Electrode design and surgical approach were predictors of scalar electrode location. Specifically, LW electrodes showed higher rates of ST insertion compared with PM or MS. RW and ERW approaches showed higher rates of ST insertion when compared with C. In regards to performance, ST insertion, younger age, and greater angular insertion depth were predictors of improved CNC scores.

AB - Objectives: 1) Investigate the impact of electrode type and surgical approach on scalar electrode location; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting: Tertiary academic hospital. Patients: Two hundred twenty post-lingually deafened adults undergoing cochlear implant (CI). Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance. Results: In 68% of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar (PM) and mid-scala (MS) electrodes were 22.4 (95% CI: 6.3-80.0, p < 0.001) and 55.0 (95% CI: 9.7-312.8, p < 0.001) times more likely to have at least one electrode in the scala vestibuli (SV) compared with lateral wall (LW) electrodes, respectively. Compared with cochleostomy (C), round window (RW) and extended round window (ERW) approaches demonstrated 70% reduction in SV insertion (RW: OR 0.28, 95% CI: 0.1-0.8, p = 0.01; ERW: OR 0.28, 95% CI: 0.1-0.7, p = 0.005). Examining postoperative audiometric performance, consonant-nucleus-consonant (CNC) score increased 0.6% with every 10 degrees increase in angular insertion depth beyond the group minimum of 208 degrees (coefficient 0.0006, 95% CI: 0.0001-0.001, p = 0.03). SV insertion was associated with a 12% decrease in CNC score (coefficient -0.12, 95% CI: -0.22 to -0.02, p = 0.02). CNC score decreased 0.3% for every 1 year increase in age (coefficient -0.003, 95% CI: -0.006 to -0.0006, p = 0.02). Conclusions: Electrode design and surgical approach were predictors of scalar electrode location. Specifically, LW electrodes showed higher rates of ST insertion compared with PM or MS. RW and ERW approaches showed higher rates of ST insertion when compared with C. In regards to performance, ST insertion, younger age, and greater angular insertion depth were predictors of improved CNC scores.

KW - Angular insertion depth

KW - Cochlear implant

KW - Electrode design

KW - Electrode location

KW - Scala tympani

KW - Scalar translocation

KW - Speech perception

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