- Original Article
- Open Access
The impact of electrode type on intraoperative and postoperative telemetry measures in cochlear implant using different surgical technique
The Egyptian Journal of Otolaryngology volume 32, pages264–270(2016)
Cochlear implantation (CI) is largely considered successful based on the device’s ability to reliably send electrical signals to the auditory nerve fibers. Telemetry (electrode impedance) is a bidirectional communication system. The telemetry system allows us to test the basic functions of a CI and to detect the electrical problems in each electrode.
The aims of this study were to monitor electrode telemetry at the intraoperative and initial-activation postoperative periods and to correlate the telemetry measures with the type of inserted electrode and surgical technique.
Patients and methods
A retrospective analysis of impedance data from 69 CI surgeries occurring at the Hearing and Speech Institute was conducted. Intraoperative and postoperative impedance values were available in 69 pediatric and adult patients during the first fitting 3 weeks to 1 month postoperatively. The data obtained in this study were divided into four groups depending on the type of implanted electrode and device used. In this research, four types of electrodes (Mid Scala, 1J, Flex 28, and Standard) and two surgical techniques (cochleostomy and round window) were used.
Findings showed that there is a statistically significant difference between intraoperative and postoperative mean average of telemetry measure for 1J and Flex 28 electrodes that increased postoperatively. There was no statistically significant difference between intraoperative and postoperative mean±SD of each of the two electrodes (Mid Scala, 1J, Flex 28, and Standard). Comparison between intraoperative and postoperative average of the four electrodes shows statistically significant difference in intraoperative average. The study also showed that there is no statistical difference between telemetry results when either cochleostomy or round-window approaches were used.
Findings of this research showed increase in postoperative impedance with all types of electrodes, which can be referred to the absence of electrical stimulation prior to initial activation of the device. There is statistically significant difference in intra-operative telemetry average between four types of used electrode.
Clark GM. Cochlear implants: fundamentals and applications. New York, NY: Springer-Verlag; 2003. 160–198
Schulman JH. Using impedance telemetry to diagnose cochlear electrode history, location and functionality. Ann Otol Rhinol Laryngol 1995; 166(Suppl):85–87.
Tykocinski M, Cohen LT, Cowan RS. Measurement and analysis of access resistance and polarization impedance in cochlear implant recipients. Otol Neurotol 2005; 26: 948–956.
Finley CC, Holden TA, Holden LK, Whiting BR, Chole RA, Neely GJ et al. Role of electrode placement as a contributor to variability in cochlear implant outcomes. Otol Neurotol 2008; 29: 920–928.
Dorman MF, Smith LM, Dankowski K, McCandless G, Parkin JL. Long-term measures of electrode impedance and auditory thresholds for the Ineraid cochlear implant. J Speech Hear Res 1992; 35: 1126–1130.
Goehring JL, Hughes ML, Baudhuin JL, Lusk RP. Otol Neurotol 2013; 34: 239–244.
Shepherd RK, Clark GM, Pyman BC, Webb RL. Banded intracochlear electrode array: evaluation of insertion trauma in human temporal bones. Ann Otol Rhinol Laryngol 1985; 94(Pt 1):55–59.
Lehnhardt E. Intracochlear placement of cochlear implant electrodes in soft surgery technique. HNO 1993; 41: 356–359.
House WF. Surgical considerations in cochlear implantation. Cochlear implants: progress and perspectives. In: House WF, Berliner KI, editors. Ann Otol Rhinol Laryngol 1982; 91(Pt 3):15–20.
Roland PS, Wright CG, Isaacson B. Cochlear implant electrode insertion: the round window revisited. Laryngoscope 2007; 117: 1397–1402.
Todt I, Basta D, Ernst A. Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo? Otolaryngol Head Neck Surg 2008; 138: 8–12.
Li PM, Somdas MA, Eddington DK, Nadol JB Jr. Analysis of intracochlear new bone and fibrous tissue formation in human subjects with cochlear implants. Ann Otol Rhinol Laryngol 2007; 116: 731–738.
Nadol JB Jr, Shiao JY, Burgess BJ, Ketten DR, Eddington DK, Gantz BJ et al. Histopathology of cochlear implants in humans. Ann Otol Rhinol Laryngol 2001; 110:883–891.
Fayad J, Linthicum FH Jr, Otto SR, Galey FR, House WF. Cochlear implants: histopathologic findings related to performance in 16 human temporal bones. Ann Otol Rhinol Laryngol 1991; 100:807–811.
Briggs RJ, Tykocinski M, Stidham K, Roberson JB. Cochleostomy site: implications for electrode placement and hearing preservation. Acta Otolaryngol 2005; 125: 870–876.
Gantz BJ, Turner C, Gfeller KE, Lowder MW. Preservation of hearing in cochlear implant surgery: advantages of combined electrical and acoustical speech processing. Laryngoscope 2005; 115: 796–802.
Lin JW, Mody A, Tonini R, Emery C, Haymond J, Vrabec JT, Oghalai JS. Characteristics of malfunctioning channels in pediatric cochlear implants. Laryngoscope 2010; 120: 399–404.
Neault M, Harris J, Kenna M, Licarneli G. Incidence and time course of individual electrode faults in pediatric cochlear implants. Poster session presented at: Objective Measures in Auditory Implants 6th International Symposium; St. Louis, MO. 2010 Sept 23–25.
Manolache O, Olariu R, Radulescu L, Cozma S. Electrical impedances variations values in patients with cochlear implant. Romanian J Oral Rehabil 2012; 4: 22–28.
Garnham J, Gibbin KP, O’Donoghue GM et al. Retrospective study of intra-operative testing with the Nucleus CI24 cochlear implant and use of the back-up device. Cochlear Implant Int 2003; 4: 1–10.
Carlson ML, Archibald DJ, Dabade TS, Gifford RH, Neff BA, Beatty CW et al. Prevalence and timing of individual cochlear implant electrode failures. Otol Neurotol 2010; 31: 893–898.
Clark GM, Shute SA, Shepherd RK, Carter TD. Cochlear implantation: osteoneogenesis, electrode-tissue impedance, and residual hearing. Ann Otol Rhinol Laryngol Suppl 1995; 166: 40–42.
Kawano A, Seldon HL, Clark GM, Ramsden RT, Raine CH. Intracochlear factors contributing to psychophysical percepts following cochlear implantation. Acta Otolaryngol 1998; 118: 313–326.
Shiroma M, Honda K, Yamanaka N, Kawano J, Yukawa K, Kumakawa K, Funasaka S. Factors contributing to phoneme recognition ability of users of the 22-channel cochlear implant system. Ann Otol Rhinol Laryngol 1992; 101: 32–37.
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Hamada, S., Omara, A., Sefein, I.K. et al. The impact of electrode type on intraoperative and postoperative telemetry measures in cochlear implant using different surgical technique. Egypt J Otolaryngol 32, 264–270 (2016). https://doi.org/10.4103/1012-5574.192548
- cochlear implant