Role of electrode placement as a contributor to variability in cochlear implant outcomes

Charles C. Finley, Timothy A. Holden, Laura K. Holden, Bruce R. Whiting, Richard A. Chole, Gail J. Neely, Timothy Hullar, Margaret W. Skinner

Research output: Contribution to journalArticle

247 Citations (Scopus)

Abstract

Hypothesis: Suboptimal cochlear implant (CI) electrode array placement may reduce presentation of coded information to the central nervous system and, consequently, limit speech recognition. Background: Generally, mean speech reception scores for CI recipients are similar across different CI systems, yet large outcome variation is observed among recipients implanted with the same device. These observations suggest significant recipient-dependent factors influence speech reception performance. This study examines electrode array insertion depth and scalar placement as recipient-dependent factors affecting outcome. Methods: Scalar location and depth of insertion of intracochlear electrodes were measured in 14 patients implanted with Advanced Bionics electrode arrays and whose word recognition scores varied broadly. Electrode position was measured using computed tomographic images of the cochlea and correlated with stable monosyllabic word recognition scores. Results: Electrode placement, primarily in terms of depth of insertion and scala tympani versus scala vestibuli location, varies widely across subjects. Lower outcome scores are associated with greater insertion depth and greater number of contacts being located in scala vestibuli. Three patterns of scalar placement are observed suggesting variability in insertion dynamics arising from surgical technique. Conclusion: A significant portion of variability in word recognition scores across a broad range of performance levels of CI subjects is explained by variability in scalar location and insertion depth of the electrode array. We suggest that this variability in electrode placement can be reduced and average speech reception improved by better selection of cochleostomy sites, revised insertion approaches, and control of insertion depth during surgical placement of the array.

Original languageEnglish (US)
Pages (from-to)920-928
Number of pages9
JournalOtology and Neurotology
Volume29
Issue number7
DOIs
StatePublished - 2008
Externally publishedYes

Fingerprint

Cochlear Implants
Electrodes
Scala Vestibuli
Bionics
Scala Tympani
Cochlea
Central Nervous System
Equipment and Supplies

Keywords

  • Cochlear implantation
  • Computed tomography
  • Electrode placement
  • Insertion depth
  • Outcome variability
  • Scalar placement

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

Finley, C. C., Holden, T. A., Holden, L. K., Whiting, B. R., Chole, R. A., Neely, G. J., ... Skinner, M. W. (2008). Role of electrode placement as a contributor to variability in cochlear implant outcomes. Otology and Neurotology, 29(7), 920-928. https://doi.org/10.1097/MAO.0b013e318184f492

Role of electrode placement as a contributor to variability in cochlear implant outcomes. / Finley, Charles C.; Holden, Timothy A.; Holden, Laura K.; Whiting, Bruce R.; Chole, Richard A.; Neely, Gail J.; Hullar, Timothy; Skinner, Margaret W.

In: Otology and Neurotology, Vol. 29, No. 7, 2008, p. 920-928.

Research output: Contribution to journalArticle

Finley, CC, Holden, TA, Holden, LK, Whiting, BR, Chole, RA, Neely, GJ, Hullar, T & Skinner, MW 2008, 'Role of electrode placement as a contributor to variability in cochlear implant outcomes', Otology and Neurotology, vol. 29, no. 7, pp. 920-928. https://doi.org/10.1097/MAO.0b013e318184f492
Finley, Charles C. ; Holden, Timothy A. ; Holden, Laura K. ; Whiting, Bruce R. ; Chole, Richard A. ; Neely, Gail J. ; Hullar, Timothy ; Skinner, Margaret W. / Role of electrode placement as a contributor to variability in cochlear implant outcomes. In: Otology and Neurotology. 2008 ; Vol. 29, No. 7. pp. 920-928.
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