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  • Title: Hearing Preservation Outcomes Using a Precurved Electrode Array Inserted With an External Sheath.
    Author: Nassiri AM, Yawn RJ, Holder JT, Dwyer RT, O'Malley MR, Bennett ML, Labadie RF, Rivas A.
    Journal: Otol Neurotol; 2020 Jan; 41(1):33-38. PubMed ID: 31746820.
    Abstract:
    OBJECTIVES: Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing. STUDY DESIGN: Retrospective review. SETTING: Tertiary otologic center. PATIENTS: Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array. INTERVENTIONS: CI, intraoperative computed tomography (CT) OUTCOME MEASURES:: Audiologic measures (consonant-nucleus-consonant [CNC] words, AzBio sentences, low-frequency pure tone averages [LFPTA]) and electrode location (scalar location, electrode-to-modiolus distance ((Equation is included in full-text article.)), angular insertion depth). RESULTS: Twenty-four adults with less than 80 dB LFPTA with a precurved electrode array inserted using an external sheath; 16 underwent intraoperative CT. LFPTA was 58.5 dB HL preoperatively, with a 17.3 dB threshold shift at CI activation (p = 0.005). CNC word scores improved from 6% preoperatively to 64% at 6 months postoperatively (p < 0.0001). There was one scalar translocation and no tip fold-overs. The average angular insertion depth was 388.2 degrees, and the average (Equation is included in full-text article.)across all electrodes was 0.36 mm. Multivariate regression revealed a significant correlation between CNC scores at 6 months and angular insertion depth (p = 0.0122; r = 0.45, adjusted r = 0.35). Change in LFPTA was not significantly associated with angular insertion depth or (Equation is included in full-text article.). CONCLUSIONS: A low rate of translocation allows a precurved electrode array inserted using an external sheath to maintain hearing preservation rates comparable to straight electrode arrays. With scala tympani insertion, angular insertion depth is a positive marker of improved speech performance postoperatively but may be a confounder variable based on individual cochlear size.
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