Skip to main content

Advertisement

SpringerLink
Log in

Cochlear implantation with the nucleus slim modiolar electrode (CI532): a preliminary experience

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

To combine the benefits of perimodiolar stimulation with minimal insertion trauma, a thin, pre-curved electrode (CI532) was recently developed by Cochlear Ltd. (Sidney). This array is held straight prior to insertion by an external polymer reloadable sheath that is removed after full electrode insertion. Sixty-seven patients suffering from severe-to-profound sensorineural hearing loss (mean age 42.2 years; mean duration of the hearing loss 19.6 years; mean PTA thresholds at 250–2000 Hz 92.4 dB HL) were implanted with the CI532. Mean duration of surgery was 58.7 min. In 61 patients, a round window (RW) approach was used. In the remaining six cases, a cochleostomy was done because of RW ossification. Impedances and NRT for each electrode are reported. NRT ratio average value was 0.86 ± 0.12 predicting correct scala tympani electrode placement. Post-operative PTA threshold in the implanted ear was 102.9 dB HL. Finally, speech recognition level in quiet at 65 dB HL was 44.6%, after a short follow-up (mean 5.2 months). Our preliminary experience with the new CI532 shows good surgical, electrophysiological, and audiological outcomes. In particular, our results are promising regarding the possibility to achieve minimal insertion trauma and good residual hearing preservation with the use of a deep inserted close modiolar electrode.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Tykocinski M, Saunders E, Cohen LT, Treaba C, Briggs RJS (2001) The Contour electrode array: safety study and initial patient trials of a new perimodiolar design. Otol Neurotol 22:33–41

    Article  CAS  PubMed  Google Scholar 

  2. Frijns JHM, De Snoo SL, Ten Kate JH (1996) Spatial selectivity in a rotationally symmetric model of the electrically stimulated cochlea. Hear Res 95:33–48

    Article  CAS  PubMed  Google Scholar 

  3. Smullen JL, Polak M, Hodges AV, Payne SB, King JE 3rd, Telischi FF, Balkany TJ (2005) Facial nerve stimulation after cochlear implantation. Laryngoscope 115:977–982

    Article  PubMed  Google Scholar 

  4. Gordin A, Papsin B, James A, Gordon K (2009) Evolution of cochlear implant arrays result in changes in behavioral and physiological responses in children. Otol Neurotol 30(7):908–915

    Article  PubMed  Google Scholar 

  5. Hughes ML, Abbas PJ (2006) Electrophysiologic channel interaction, electrode pitch ranking, and behavioral threshold in straight versus perimodiolar cochlear implant electrode arrays. J Acoust Soc Am 119:1538–1547

    Article  PubMed  Google Scholar 

  6. Holden LK, Finley CC, Firszt JB, Holden TA, Brenner C, Potts LG, Gotter BD, Vanderhoof SS, Mispagel K, Heydebrand G, Skinner MW (2013) Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear 34(3):342–360

    Article  PubMed  PubMed Central  Google Scholar 

  7. Carlson ML, Driscoll CL, Gifford RH, Service GJ, Tombers NM, Hughes-Borst BJ, Neff BA, Beatty CW (2011) Implications of minimizing trauma during conventional cochlear implantation. Otol Neurotol 32:962–968

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gifford RH, Dorman MF, Skarzynski H, Lorens A, Polak M, Driscoll CL, Roland P, Buchman CA (2013) Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments. Ear Hear 34:413–425

    Article  PubMed  PubMed Central  Google Scholar 

  9. Skarzynski H, Lorens A, Matusiak M, Porowski M, Skarzynski PH, James CJ (2014) Cochlear implantation with the nucleus slim straight electrode in subjects with residual low-frequency hearing. Ear Hear 35:33–43

    Article  Google Scholar 

  10. D’Elia A, Bartoli R, Giagnotti F, Quaranta N (2012) The role of hearing preservation on electrical thresholds and speech performances in cochlear implantation. Otol Neurotol 33(3):343–347

    Article  Google Scholar 

  11. O’Connell BP, Cakir A, Hunter JB, Francis DO, Noble JH, Labadie RF, Zuniga G, Dawant BM, Rivas A, Wanna GB (2016) Electrode location and angular insertion depth are predictors of audiologic outcomes in cochlear implantation. Otol Neurotol 37(8):1016–1023

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wanna GB, Noble JH, Carlson ML, Gifford RH, Dietrich MS, Haynes DS, Dawant BM, Labadie RF (2014) Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes. Laryngoscope 124(Suppl 6):S1-7

    PubMed  Google Scholar 

  13. Roland JT (2005) A model for cochlear implant electrode insertion and force evaluation: results with a new electrode design and insertion technique. Laryngoscope 115:1325–1339

    Article  PubMed  Google Scholar 

  14. Aschendorff A, Kromeier J, Klenzner T, Laszig R (2007) Quality control after insertion of the nucleus contour and contour advance electrode in adults. Ear Hear 28(2):75–79

    Article  Google Scholar 

  15. Fraysse B, Macías ÁR, Sterkers O, Burdo S, Ramsden R, Deguine O, Klenzner T, Lenarz T, Rodriguez MM, Von Wallenberg E, James C (2006) Residual hearing conservation and electroacoustic stimulation with the Nucleus 24 Contour Advance cochlear implant. Otol Neurotol 27:624–663

    Article  PubMed  Google Scholar 

  16. Briggs RJ, Tykocinski M, Lazsig R, Aschendorff A, Lenarz T, Stöver T, Fraysse B, Marx M, Roland JT Jr, Roland PS, Wright CG, Gantz BJ, Patrick JF, Risi F (2011) Development and evaluation of the modiolar research array–multi-centre collaborative study in human temporal bones. Cochlear Implants Int 12(3):129–139

    Article  PubMed  PubMed Central  Google Scholar 

  17. Turrini M, Cutugno F, Maturi P, Prosser S, Leoni FA, Arslan E (1992) Bisyllabic words for speech audiometry: a new Italian material. Acta Otorhinolaryngol Ital 13(1):63–77

    Google Scholar 

  18. Mittmann P, Ernst A, Todt I (2015) Intraoperative electrophysiologic variations caused by the scalar position of Cochlear implant electrodes. Otol Neurotol 36(6):1010–1014

    Article  PubMed  Google Scholar 

  19. Briggs RJ, Tykocinski M, Saunders E, Hellier W, Dahm M, Pyman B, Clark GM (2001) Surgical implications of perimodiolar cochlear implant electrode design: avoiding intracochlear damage and scala vestibuli insertion. Cochlear Implants Int 2:135–149

    Article  CAS  PubMed  Google Scholar 

  20. Skarzynski H, Lorens A, Matusiak M et al (2012) Partial deafness treatment with the nucleus straight research array cochlear implant. Audiol Neurotol 17:82–91

    Article  Google Scholar 

  21. Ariyasu L, Galey FR, Hilsinger RJR, Byl FM (1989) Computer-generated three-dimensional reconstruction of the cochlea. Otolaryngol Head Neck Surg 100(2):87

    Article  CAS  PubMed  Google Scholar 

  22. Stakhovskaya O, Sridhar D, Bonham BH, Leake PA (2007) Frequency map for the human cochlear spiral ganglion: implications for cochlear implants. JARO 8(2):220–223

    Article  PubMed  PubMed Central  Google Scholar 

  23. Adunka O, Kiefer J (2006) Impact of electrode insertion depth on intracochlear trauma. Otolarygol Head Neck Surg 135:374–382

    Article  Google Scholar 

  24. Boyd PJ (2011) Potential benefits from deeply inserted cochlear implant electrodes. Ear Hear 32(4):411–427

    Article  PubMed  Google Scholar 

  25. Gani M, Valentini G, Sigrist A, Kós MI, Boëx C (2007) Implications of deep electrode insertion on cochlear implant fitting. JARO 8(1):69–83

    Article  PubMed  PubMed Central  Google Scholar 

  26. Gordon K, Papsin B. From Nucleus 24 to 513. (2013) Changing Cochlear Implant design affects auditory response thresholds. Otol Neurotol 34:436–442

  27. Seidman MD, Vivek P, Dickinson W (2005) Neural response telemetry results with the nucleus 24 contour in a perimodiolar position. Otol Neurotol 26.4:620–623

    Article  Google Scholar 

  28. Grolman W, Maat A, Verdam F, Simi Y, Carelsen B, Freling N, Tange RA (2009) Spread of excitation measurements for the detection of electrode array foldovers: a prospective study comparing 3-dimensional rotational X-ray and intraoperative spread of excitation measurements. Otol Neurotol 30(1):27–33

    Article  PubMed  Google Scholar 

  29. Copeland BJ, Pillsbury HC, Buchman CA (2004) Prospective evaluation of intraoperative cochlear implant radiographs. Otol Neurotol 25(3):295–297

    Article  PubMed  Google Scholar 

  30. Gnagi SH, Baker TR, Pollei TR, Barrs DM (2015) Analysis of Intraoperative Radiographic Electrode Placement During Cochlear Implantation. Otol Neurotol 36(6):1045–1047

    Article  PubMed  Google Scholar 

  31. Ying YLM, Lin JW, Oghalai JS, Williamson RA (2013) Cochlear implant electrode misplacement: incidence, evaluation, and management. Laryngoscope 123(3):757–766

    Article  PubMed  PubMed Central  Google Scholar 

  32. Carlson ML, Driscoll CL, Gifford RH, Service GJ, Tombers NM, Hughes-Borst BJ, Neff BA, Beatty CW (2011) Implications of minimizing trauma during conventional cochlear implantation. Otol Neurotol 32(6):962–968

    Article  PubMed  PubMed Central  Google Scholar 

  33. Balkany TJ, Connell SS, Hodges AV, Payne SL, Telischi FF, Eshraghi AA, Angeli SI, Germani R, Messiah S, Arheart KL (2006) Conservation of residual acoustic hearing after cochlear implantation. Otol Neurotol 27:1083–1088

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, ‘Guglielmo da Saliceto’ Hospital, Via Cantone del Cristo 40, 29121, Piacenza, Italy

    Domenico Cuda & Alessandra Murri

Authors
  1. Domenico Cuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra Murri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandra Murri.

Ethics declarations

Conflict of interest

All authors deny any conflict of interest. We did not have any financial interest or support in this work.

Additional information

This material has never been published and is not currently under evaluation in any other peer-reviewed publication.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cuda, D., Murri, A. Cochlear implantation with the nucleus slim modiolar electrode (CI532): a preliminary experience. Eur Arch Otorhinolaryngol 274, 4141–4148 (2017). https://doi.org/10.1007/s00405-017-4774-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-017-4774-6

Keywords

Search

Navigation