PMID- 24764083
OWN - NLM
STAT- MEDLINE
DCOM- 20141222
LR  - 20220410
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Print)
IS  - 0023-852X (Linking)
VI  - 124 Suppl 6
IP  - 0 6
DP  - 2014 Nov
TI  - Impact of electrode design and surgical approach on scalar location and cochlear 
      implant outcomes.
PG  - S1-7
LID - 10.1002/lary.24728 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Three surgical approaches: cochleostomy (C), round window 
      (RW), and extended round window (ERW); and two electrodes types: lateral wall 
      (LW) and perimodiolar (PM), account for the vast majority of cochlear 
      implantations. The goal of this study was to analyze the relationship between 
      surgical approach and electrode type with final intracochlear position of the 
      electrode array and subsequent hearing outcomes. STUDY DESIGN: Comparative 
      longitudinal study. METHODS: One hundred postlingually implanted adult patients 
      were enrolled in the study. From the postoperative scan, intracochlear electrode 
      location was determined and using rigid registration, transformed back to the 
      preoperative computed tomography which had intracochlear anatomy (scala tympani 
      and scala vestibuli) specified using a statistical shape model based on 10 
      microCT scans of human cadaveric cochleae. Likelihood ratio chi-square statistics 
      were used to evaluate for differences in electrode placement with respect to 
      surgical approach (C, RW, ERW) and type of electrode (LW, PM). RESULTS: Electrode 
      placement completely within the scala tympani (ST) was more common for LW than 
      were PM designs (89% vs. 58%; P < 0.001). RW and ERW approaches were associated 
      with lower rates of electrode placement outside the ST than was the cochleostomy 
      approach (9%, 16%, and 63%, respectively; P < 0.001). This pattern held true 
      regardless of whether the implant was LW or PM. When examining electrode 
      placement and hearing outcome, those with electrode residing completely within 
      the ST had better consonant-nucleus-consonant word scores than did patients with 
      any number of electrodes located outside the ST (P = 0.045). CONCLUSION: These 
      data suggest that RW and ERW approaches and LW electrodes are associated with an 
      increased likelihood of successful ST placement. Furthermore, electrode position 
      entirely within the ST confers superior audiological outcomes. LEVEL OF EVIDENCE: 
      2b.
CI  - (c) 2014 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Wanna, George B
AU  - Wanna GB
AD  - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, 
      Nashville, Tennessee, U.S.A.
FAU - Noble, Jack H
AU  - Noble JH
FAU - Carlson, Matthew L
AU  - Carlson ML
FAU - Gifford, Rene H
AU  - Gifford RH
FAU - Dietrich, Mary S
AU  - Dietrich MS
FAU - Haynes, David S
AU  - Haynes DS
FAU - Dawant, Benoit M
AU  - Dawant BM
FAU - Labadie, Robert F
AU  - Labadie RF
LA  - eng
GR  - R21DC012620/DC/NIDCD NIH HHS/United States
GR  - R01DC009404/DC/NIDCD NIH HHS/United States
GR  - R01DC008408/DC/NIDCD NIH HHS/United States
GR  - R01 DC009404/DC/NIDCD NIH HHS/United States
GR  - R01 DC008408/DC/NIDCD NIH HHS/United States
GR  - R21 DC012620/DC/NIDCD NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20140530
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adult
MH  - Cochlea/surgery
MH  - Cochlear Implantation/*methods
MH  - *Cochlear Implants
MH  - *Electrodes, Implanted
MH  - Female
MH  - Hearing Loss, Sensorineural/*surgery
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - *Prosthesis Design
MH  - Scala Tympani/*surgery
MH  - Treatment Outcome
PMC - PMC4209201
MID - NIHMS591277
OTO - NOTNLM
OT  - Cochlear implant
OT  - cochleostomy
OT  - electrode
OT  - round window
OT  - sensorineural hearing loss
EDAT- 2014/04/26 06:00
MHDA- 2014/12/23 06:00
PMCR- 2015/11/01
CRDT- 2014/04/26 06:00
PHST- 2014/03/11 00:00 [received]
PHST- 2014/04/16 00:00 [revised]
PHST- 2014/04/21 00:00 [accepted]
PHST- 2014/04/26 06:00 [entrez]
PHST- 2014/04/26 06:00 [pubmed]
PHST- 2014/12/23 06:00 [medline]
PHST- 2015/11/01 00:00 [pmc-release]
AID - 10.1002/lary.24728 [doi]
PST - ppublish
SO  - Laryngoscope. 2014 Nov;124 Suppl 6(0 6):S1-7. doi: 10.1002/lary.24728. Epub 2014 
      May 30.