Abstract
Background
Incomplete partition type III (IP III) is defined by a missing lamina cribrosa between the cochlea and the internal auditory canal (IAC). Cochlear implantation (CI) may result in an insertion of the electrode array into the IAC. The aim of this study is to evaluate CI surgery protocols, long-term audiological outcome, mapping and electrophysiological data after CI in IP III patients.
Materials and methods
Nine IP III patients were implanted with perimodiolar electrode arrays between 1999 and 2014; eight of them were included in this study. We evaluated mapping data, stapedius reflexes, electrode impedances and ECAP thresholds. We matched them with 3 CI patients each with normal cochlear morphology regarding sex, age, side, implant type and surgical date. Speech discrimination was evaluated with the Oldenburger sentence test for adults, Göttingen audiometric speech test for children and the Freiburger monosyllabic word test.
Results
3 years after CI IP III patients showed a significant increase in pulse width, calculated electric load and electrode impedances in basal electrodes. Intraoperative electrically-evoked stapedius reflexes could be measured in all patients. Speech recognition scores were lower than average scores for matched patients, but without statistical significance.
Conclusions
The significant increase of pulse width, electric load and electrode impedances of basal electrodes over time seem to be characteristic for IP III patients probably occurring due to fibrosis and neurodegeneration of the cochlear nerve. The long term audiological results are stable. Intraoperative imaging and stapedius reflexes are highly recommended to control the right position of the electrode array.
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Acknowledgements
The authors thank the support organisation “Taube Kinder lernen Hören e. V.”, which has supported the cochlear implant rehabilitation center in Freiburg.
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Ketterer, MC, M.D. analyzed data and wrote the paper. Alballaa, A. provided statistical analysis together with Becker, Ch., M.D. Wesarg, T, PhD., contributed to data analysis and provided critical revision; Aschendorff, A., M.D., PhD, provided critical revision and surgical analysis. The other coauthors provided critical revision.
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A. Aschendorff received travelling expenses and financial support for research from Advanced Bionics, Stäfa, Switzerland; financial support for research and travelling expenses from Cochlear Ltd, Australia; financial support for research and travelling expenses from Med-El, Innsbruck, Austria; travelling expenses and financial support for research from Oticon, Copenhagen, Denmark. S. Arndt received travelling expenses from Advanced Bionics, Stäfa, Switzerland; financial support for research and travelling expenses from Cochlear Ltd, Australia; financial support for research and travelling expenses from Med-El, Innsbruck, Austria and travelling expenses from Oticon, Copenhagen, Denmark. R. Laszig received financial support for research and travelling expenses from Advanced Bionics, Stäfa, Switzerland; financial support for research, travelling expenses and consultancy fees from Cochlear Ltd, Australia; travelling expenses from Oticon, Copenhagen, Denmark; financial support for research from Med-El, Innsbruck, Austria; financial support for research and travelling expenses from ARRIAG Munich, Germany; travelling expenses from Otologics Boulder, USA; travelling expenses from SonovaHolding, Stäfa, Switzerland; travelling expenses from the General Secretary of the German ENT Society; contract fees, consultancy fees and travelling costs from Medupdate and fees from Springer Medicine EiC. R. Beck received travelling expenses from Cochlear Ltd, Australia. This study was not sponsored by industry. M.C. Ketterer, C. Becker, T. Hildenbrand, F. Hassepass, T. Wesarg, A. Alballaa and I. Speck declare that they have no competing interests.
Retrospective study; compliance with ethical standards is given and the authors have no funding, financial relationships or conflicts of interest to declare.
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The German version of this article can be found under https://doi.org/10.1007/s00106-019-00733-y.
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Alballaa, A., Aschendorff, A., Arndt, S. et al. Incomplete partition type III revisited—long-term results following cochlear implant. HNO 68 (Suppl 1), 25–32 (2020). https://doi.org/10.1007/s00106-019-00732-z
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DOI: https://doi.org/10.1007/s00106-019-00732-z