Evaluation of outcome variability associated with lateral wall mid-scalar, and perimodiolar electrode arrays when controlling for preoperative patient characteristics

Joshua E. Fabie, Robert G. Keller, Jonathan L. Hatch, Meredith A. Holcomb, Elizabeth L. Camposeo, Paul R. Lambert, Ted A. Meyer, Theodore R. McRackan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: Determine the impact of electrode array selection on audiometric performance when controlling for baseline patient characteristics. Study Design: Retrospective evaluation of a prospective cochlear implant (CI) database (January 1, 2012-May 31 2017). Setting: Tertiary Care University Hospital. Patients: Three hundred twenty-eight adult CI recipients. Interventions/Main Outcomes Measured: Hearing outcomes were measured through unaided/aided pure tone thresholds and speech recognition testing before and after cochlear implantation. All reported postoperative results were performed at least 6 months after CI activation. All device manufacturers were represented. Results: Of the 328 patients, 234 received lateral wall (LW) arrays, 46 received perimodiolar (PM) arrays, and 48 received mid-scalar (MS) arrays. Patients receiving PM arrays had significantly poorer preoperative earphone and aided PTAs and SRTs, and aided Consonant-Nucleus-Consonant( CNC) word and AzBio +10 SNR scores compared with patients receiving LW arrays (all p<0.04), and poorer PTAs and AzBio +10 SNR scores compared with MS recipients (all p<0.02). No preoperative audiological variables were found to significantly differ between MS and LW patients. After controlling for preoperative residual hearing and speech recognition ability in a hierarchical multiple regression analysis, no statistically significant difference in audiological outcomes was detected (CNC words, AzBio quiet, or AzBio +10 SNR) among the three electrode array types (all p>0.05). Conclusion: While previous studies have demonstrated superior postoperative speech recognition scores in LW electrode array recipients, these differences lose significance when controlling for baseline hearing and speech recognition ability. These data demonstrate the proclivity for implanting individuals with greater residual hearing with LW electrodes and its impact on postoperative results.

Original languageEnglish (US)
Pages (from-to)1122-1128
Number of pages7
JournalOtology and Neurotology
Volume39
Issue number9
DOIs
StatePublished - Jan 1 2018

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Electrodes
Cochlear Implants
Hearing
Cochlear Implantation
Aptitude
Tertiary Healthcare
Retrospective Studies
Databases
Equipment and Supplies

Keywords

  • Cochlear implant
  • Hearing
  • Sensorineural hearing loss

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Evaluation of outcome variability associated with lateral wall mid-scalar, and perimodiolar electrode arrays when controlling for preoperative patient characteristics. / Fabie, Joshua E.; Keller, Robert G.; Hatch, Jonathan L.; Holcomb, Meredith A.; Camposeo, Elizabeth L.; Lambert, Paul R.; Meyer, Ted A.; McRackan, Theodore R.

In: Otology and Neurotology, Vol. 39, No. 9, 01.01.2018, p. 1122-1128.

Research output: Contribution to journalArticle

Fabie, Joshua E. ; Keller, Robert G. ; Hatch, Jonathan L. ; Holcomb, Meredith A. ; Camposeo, Elizabeth L. ; Lambert, Paul R. ; Meyer, Ted A. ; McRackan, Theodore R. / Evaluation of outcome variability associated with lateral wall mid-scalar, and perimodiolar electrode arrays when controlling for preoperative patient characteristics. In: Otology and Neurotology. 2018 ; Vol. 39, No. 9. pp. 1122-1128.
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AB - Objective: Determine the impact of electrode array selection on audiometric performance when controlling for baseline patient characteristics. Study Design: Retrospective evaluation of a prospective cochlear implant (CI) database (January 1, 2012-May 31 2017). Setting: Tertiary Care University Hospital. Patients: Three hundred twenty-eight adult CI recipients. Interventions/Main Outcomes Measured: Hearing outcomes were measured through unaided/aided pure tone thresholds and speech recognition testing before and after cochlear implantation. All reported postoperative results were performed at least 6 months after CI activation. All device manufacturers were represented. Results: Of the 328 patients, 234 received lateral wall (LW) arrays, 46 received perimodiolar (PM) arrays, and 48 received mid-scalar (MS) arrays. Patients receiving PM arrays had significantly poorer preoperative earphone and aided PTAs and SRTs, and aided Consonant-Nucleus-Consonant( CNC) word and AzBio +10 SNR scores compared with patients receiving LW arrays (all p<0.04), and poorer PTAs and AzBio +10 SNR scores compared with MS recipients (all p<0.02). No preoperative audiological variables were found to significantly differ between MS and LW patients. After controlling for preoperative residual hearing and speech recognition ability in a hierarchical multiple regression analysis, no statistically significant difference in audiological outcomes was detected (CNC words, AzBio quiet, or AzBio +10 SNR) among the three electrode array types (all p>0.05). Conclusion: While previous studies have demonstrated superior postoperative speech recognition scores in LW electrode array recipients, these differences lose significance when controlling for baseline hearing and speech recognition ability. These data demonstrate the proclivity for implanting individuals with greater residual hearing with LW electrodes and its impact on postoperative results.

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