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Electrode Location and Audiologic Performance After Cochlear Implantation

A Comparative Study Between Nucleus CI422 and CI512 Electrode Arrays

O’Connell, Brendan P.; Hunter, Jacob B.; Gifford, René H.; Rivas, Alejandro; Haynes, David S.; Noble, Jack H.; Wanna, George B.

doi: 10.1097/MAO.0000000000001140
COCHLEAR IMPLANTS
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Objectives: 1) Compare rates of scala tympani (ST) insertion between Nucleus CI422 Slim Straight electrodes and Nucleus CI512 Contour Advance electrodes; 2) examine audiometric performance with both electrode arrays, while controlling for electrode location.

Setting: Tertiary academic hospital.

Patients: Fifty-six post-lingually deafened adults undergoing cochlear implant (CI).

Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance.

Results: Fifty-six implants in 49 patients were included; 20 were implanted with Nucleus CI422 Slim Straight electrodes, and 36 were implanted with Nucleus CI512 Contour Advance electrodes. Overall, 62.5% (35 of 56) of implants had all electrodes located within the ST. Significantly, higher rates of ST insertion (90%) were observed for Nucleus CI422 Slim Straight electrodes when compared with Nucleus CI512 Contour Advance electrodes (47.2%) (p = 0.002). In regards to audiologic performance, consonant-nucleus-consonant (CNC) scores were significantly higher for Nucleus CI422 Slim Straight electrodes (55.4%) compared with Nucleus CI512 Contour Advance electrodes (36.5%) (p = 0.005). In addition, AzBio scores were better for Nucleus CI422 Slim Straight electrodes (71.2%) when compared with Nucleus CI512 Contour Advance electrodes (46.7%) (p = 0.004). Controlling for ST insertion, higher AzBio scores were again observed for Nucleus CI422 Slim Straight electrodes (p = 0.02).

Conclusions: The results of this study demonstrate that the Nucleus CI422 Slim Straight electrode is more likely to reside entirely within the ST when compared with the Nucleus CI512 Contour Advance electrode. Furthermore, AzBio scores were superior for patients with Nucleus CI422 Slim Straight electrodes in all patients, as well as those with only ST insertions.

*Department of Otolaryngology–Head and Neck Surgery

Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, Tennessee

Address correspondence and reprint requests to George B. Wanna, M.D., Department of Otolaryngology–Head and Neck Surgery, The Bill Wilkerson Center for Otolaryngology & Communication Sciences 7209 Medical Center East, South Tower 1215 21st Avenue South, Nashville, TN 37232-8605; E-mail: george.wanna@vanderbilt.edu

The project was supported by grants R01DC008408, R01DC014462, and R01DC014037 from the National Institute on Deafness and Other Communication Disorders and UL1TR000445 from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not represent the official views of these institutes.

This article will be presented at American Cochlear Implant Alliance: May 2016 in Toronto, CA.

IRB approval: This study was approved by the Vanderbilt IRB #090155.

Dr. Wanna is a consultant for MED-EL, Advanced Bionics, Oticon Medical, and Cochlear Americas. Dr. Rivas is a consultant for MED-EL, Advanced Bionics, Cochlear Americas, Stryker and Grace Medical. Dr. Gifford is on the advisory board of Advanced Bionics, MedEl, and Cochlear Americas. Dr. Haynes is a consultant for Cochlear, Advanced Bionics, Grace Medical, MedEl, Stryker, Synthes.

Copyright © 2016 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company