Incidence of Cochlear Implant Electrode Contacts in the Functional Acoustic Hearing Region and the Influence on Speech Recognition with Electric-Acoustic Stimulation

Overview

Journal Otol Neurotol

Specialties Neurology
Otorhinolaryngology

Date 2023 Sep 27

PMID 37758328

Authors

Evan P Nix

Nicholas J Thompson

Kevin D Brown

Matthew M Dedmon

A Morgan Selleck

Andrea B Overton

Michael W Canfarotta

Margaret T Dillon

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the incidence of electrode contacts within the functional acoustic hearing region in cochlear implant (CI) recipients and to assess its influence on speech recognition for electric-acoustic stimulation (EAS) users.

Study Design: Retrospective review.

Setting: Tertiary referral center.

Patients: One hundred five CI recipients with functional acoustic hearing preservation (≤80 dB HL at 250 Hz).

Interventions: Cochlear implantation with a 24-, 28-, or 31.5-mm lateral wall electrode array.

Main Outcome Measures: Angular insertion depth (AID) of individual contacts was determined from imaging. Unaided acoustic thresholds and AID were used to calculate the proximity of contacts to the functional acoustic hearing region. The association between proximity values and speech recognition in quiet and noise for EAS users at 6 months postactivation was reviewed.

Results: Sixty percent of cases had one or more contacts within the functional acoustic hearing region. Proximity was not significantly associated with speech recognition in quiet. Better performance in noise was observed for cases with close correspondence between the most apical contact and the upper edge of residual hearing, with poorer results for increasing proximity values in either the basal or apical direction ( r14 = 0.48, p = 0.043; r18 = -0.41, p = 0.045, respectively).

Conclusion: There was a high incidence of electrode contacts within the functional acoustic hearing region, which is not accounted for with default mapping procedures. The variability in outcomes across EAS users with default maps may be due in part to electric-on-acoustic interference, electric frequency-to-place mismatch, and/or failure to stimulate regions intermediate between the most apical electrode contact and the functional acoustic hearing region.

References

Stakhovskaya O, Sridhar D, Bonham B, Leake P . Frequency map for the human cochlear spiral ganglion: implications for cochlear implants. J Assoc Res Otolaryngol. 2007; 8(2):220-33. PMC: 2394499. DOI: 10.1007/s10162-007-0076-9. View

Giardina C, Canfarotta M, Thompson N, Fitzpatrick D, Hodge S, Baker J . Assessing Cochlear Implant Insertion Angle From an Intraoperative X-ray Using a Rotating 3D Helical Scala Tympani Model. Otol Neurotol. 2020; 41(6):e686-e694. PMC: 9011168. DOI: 10.1097/MAO.0000000000002638. View

Friesen L, Shannon R, Baskent D, Wang X . Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants. J Acoust Soc Am. 2001; 110(2):1150-63. DOI: 10.1121/1.1381538. View

Gstoettner W, Van de Heyning P, Fitzgerald OConnor A, Morera C, Sainz M, Vermeire K . Electric acoustic stimulation of the auditory system: results of a multi-centre investigation. Acta Otolaryngol. 2008; 128(9):968-75. DOI: 10.1080/00016480701805471. View

Spahr A, Dorman M, Litvak L, Van Wie S, Gifford R, Loizou P . Development and validation of the AzBio sentence lists. Ear Hear. 2011; 33(1):112-7. PMC: 4643855. DOI: 10.1097/AUD.0b013e31822c2549. View

Jensen M, Isaac H, Hernandez H, Oleson J, Dunn C, Gantz B . Timing of Acoustic Hearing Changes After Cochlear Implantation. Laryngoscope. 2021; 132(10):2036-2043. PMC: 9177890. DOI: 10.1002/lary.29984. View

Fu Q, Galvin 3rd J, Wang X . Integration of acoustic and electric hearing is better in the same ear than across ears. Sci Rep. 2017; 7(1):12500. PMC: 5624923. DOI: 10.1038/s41598-017-12298-3. View

Payne J, Au A, Dowell R . An overview of factors affecting bimodal and electric-acoustic stimulation (EAS) speech understanding outcomes. Hear Res. 2023; 431:108736. DOI: 10.1016/j.heares.2023.108736. View

Wanna G, OConnell B, Francis D, Gifford R, Hunter J, Holder J . Predictive factors for short- and long-term hearing preservation in cochlear implantation with conventional-length electrodes. Laryngoscope. 2017; 128(2):482-489. PMC: 5741536. DOI: 10.1002/lary.26714. View

10.

Perkins E, Lee J, Manzoor N, OMalley M, Bennett M, LaBadie R . The Reality of Hearing Preservation in Cochlear Implantation: Who Is Utilizing EAS?. Otol Neurotol. 2021; 42(6):832-837. PMC: 8627182. DOI: 10.1097/MAO.0000000000003074. View

11.

Kiefer J, Pok M, Adunka O, Sturzebecher E, Baumgartner W, Schmidt M . Combined electric and acoustic stimulation of the auditory system: results of a clinical study. Audiol Neurootol. 2005; 10(3):134-44. DOI: 10.1159/000084023. View

12.

Dillon M, OConnell B, Canfarotta M, Buss E, Hopfinger J . Effect of Place-Based Versus Default Mapping Procedures on Masked Speech Recognition: Simulations of Cochlear Implant Alone and Electric-Acoustic Stimulation. Am J Audiol. 2022; 31(2):322-337. PMC: 9524846. DOI: 10.1044/2022_AJA-21-00123. View

13.

Landsberger D, Svrakic M, Roland Jr J, Svirsky M . The Relationship Between Insertion Angles, Default Frequency Allocations, and Spiral Ganglion Place Pitch in Cochlear Implants. Ear Hear. 2015; 36(5):e207-13. PMC: 4549170. DOI: 10.1097/AUD.0000000000000163. View

14.

Usami S, Moteki H, Tsukada K, Miyagawa M, Nishio S, Takumi Y . Hearing preservation and clinical outcome of 32 consecutive electric acoustic stimulation (EAS) surgeries. Acta Otolaryngol. 2014; 134(7):717-27. PMC: 4086239. DOI: 10.3109/00016489.2014.894254. View

15.

Sheffield S, Gifford R . The benefits of bimodal hearing: effect of frequency region and acoustic bandwidth. Audiol Neurootol. 2014; 19(3):151-63. PMC: 4104148. DOI: 10.1159/000357588. View

16.

Imsiecke M, Buchner A, Lenarz T, Nogueira W . Psychoacoustic and electrophysiological electric-acoustic interaction effects in cochlear implant users with ipsilateral residual hearing. Hear Res. 2019; 386:107873. DOI: 10.1016/j.heares.2019.107873. View

17.

PETERSON G, LEHISTE I . Revised CNC lists for auditory tests. J Speech Hear Disord. 1962; 27:62-70. DOI: 10.1044/jshd.2701.62. View

18.

Gantz B, Dunn C, Oleson J, Hansen M, Parkinson A, Turner C . Multicenter clinical trial of the Nucleus Hybrid S8 cochlear implant: Final outcomes. Laryngoscope. 2016; 126(4):962-73. PMC: 4803613. DOI: 10.1002/lary.25572. View

19.

STUDEBAKER G . A "rationalized" arcsine transform. J Speech Hear Res. 1985; 28(3):455-62. DOI: 10.1044/jshr.2803.455. View

20.

Spitzer E, Waltzman S, Landsberger D, Friedmann D . Acceptance and Benefits of Electro-Acoustic Stimulation for Conventional-Length Electrode Arrays. Audiol Neurootol. 2020; 26(1):17-26. DOI: 10.1159/000507975. View