Skip to main content

Advertisement

SpringerLink
Log in

Early activation after cochlear implantation: a systematic review

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

Abstract

Purpose

To systematically review the outcomes of early activation following cochlear implantation (CI) based on the findings from different studies in the literature.

Methods

A comprehensive search strategy was conducted through different databases to identify relevant articles. Our outcomes included impedance levels, rates of complications, hearing and speech perception performance, and patients' satisfaction levels.

Results

The total number of included studies in this systematic review is 19, which recruited 1157 patients, including 857 who underwent early activation following CI. Seventeen studies investigated impedance levels or feasibility rates of early activation approaches. Most of these studies (n = 10) reported that mean impedance levels remarkably decreased within the first day-to-month (first measurement) post-activation. In addition, all 17 studies showed that impedance levels finally normalize and become comparable with intraoperative levels or the conventional activation group. Seventeen studies reported the occurrence of complications in their population. Ten of these studies indicated that none of their patients developed any post-operative complications after early activation. Seven studies reported the development of some minor complications, including pain 9.2% (28/304), infection 4.7% (13/275), swelling 8.2% (25/304), vertigo 15.1% (8/53), skin hyperemia 2.2% (5/228), and others 16.4% (9/55). Hearing and speech perception was assessed in six studies, which showed a remarkable improvement in their patients. Three studies investigated patients' satisfaction and showed high satisfaction levels. Only one report investigated the economic advantages of early activation.

Conclusion

Early activation is safe and feasible and does not impact the hearing and speech outcomes of the patients undergoing CI procedures.

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

Similar content being viewed by others

Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

References

  1. Hoppe U, Liebscher T, Hornung J (2016) Anpassung von Cochleaimplantatsystemen. HNO, p 65

  2. Lenarz T (2017) Cochlear Implant—state of the art. Laryngorhinootologie 96(S01):S123–S151

    PubMed  Google Scholar 

  3. Chen JK, Chuang AY, McMahon C, Hsieh JC, Tung TH, Li LP (2010) Music training improves pitch perception in prelingually deafened children with cochlear implants. Pediatrics 125(4):e793-800

    Article  PubMed  Google Scholar 

  4. Chen JK, Chuang AY, McMahon C, Tung TH, Li LP (2014) Contribution of nonimplanted ear to pitch perception for prelingually deafened cochlear implant recipients. Otol Neurotol 35(8):1409–1414

    Article  PubMed  Google Scholar 

  5. Rader T, Haerterich M, Ernst B, Stöver T, Strieth S (2017) Lebensqualität und Schwindel bei bilateraler Cochleaimplantation: Fragebogeninstrumente zur Qualitätssicherung. HNO, 66

  6. Sun CH, Chang CJ, Hsu CJ, Wu HP (2019) Feasibility of early activation after cochlear implantation. Clin Otolaryngol 44(6):1004–1010

    Article  PubMed  Google Scholar 

  7. Neuburger J, Lenarz T, Lesinski-Schiedat A, Büchner A (2009) Spontaneous increases in impedance following cochlear implantation: suspected causes and management. Int J Audiol 48(5):233–239

    Article  CAS  PubMed  Google Scholar 

  8. Webb RL, Clark GM, Shepherd RK, Franz BK, Pyman BC (1988) The biologic safety of the Cochlear Corporation multiple-electrode intracochlear implant. Am J Otol 9(1):8–13

    CAS  PubMed  Google Scholar 

  9. Clark GM, Shute SA, Shepherd RK, Carter TD (1995) Cochlear implantation: osteoneogenesis, electrode-tissue impedance, and residual hearing. Ann Otol Rhinol Laryngol Suppl 166:40–42

    CAS  PubMed  Google Scholar 

  10. Tykocinski M, Cohen LT, Cowan RS (2005) Measurement and analysis of access resistance and polarization impedance in cochlear implant recipients. Otol Neurotol 26(5):948–956

    Article  PubMed  Google Scholar 

  11. Newbold C, Mergen S, Richardson R, Seligman P, Millard R, Cowan R et al (2014) Impedance changes in chronically implanted and stimulated cochlear implant electrodes. Cochlear Implants Int 15(4):191–199

    Article  PubMed  Google Scholar 

  12. Newbold C, Richardson R, Huang CQ, Milojevic D, Cowan R, Shepherd R (2004) An in vitro model for investigating impedance changes with cell growth and electrical stimulation: implications for cochlear implants. J Neural Eng 1(4):218–227

    Article  PubMed  Google Scholar 

  13. Hagr A, Garadat SN, Al-Momani M, Alsabellha RM, Almuhawas FA (2015) Feasibility of one-day activation in cochlear implant recipients. Int J Audiol 54(5):323–328

    Article  PubMed  Google Scholar 

  14. Zeh R, Baumann U (2015) Stationäre Rehabilitationsmaßnahmen bei erwachsenen CI-Trägern. HNO 63(8):557–576

    Article  CAS  PubMed  Google Scholar 

  15. Alsabellha RM, Hagr A, Al-Momani MO, Garadat SN (2014) Cochlear implant device activation and programming: 5 days postimplantation. Otol Neurotol 35(4):e130–e134

    Article  PubMed  Google Scholar 

  16. Marsella P, Scorpecci A, Pacifico C, Resca A, Vallarino MV, Ingrosso A et al (2014) Safety and functional results of early cochlear implant switch-on in children. Otol Neurotol 35(2):277–282

    Article  PubMed  Google Scholar 

  17. Vaerenberg B, Smits C, De Ceulaer G, Zir E, Harman S, Jaspers N et al (2014) Cochlear implant programming: a global survey on the state of the art. TheScientificWorldJOURNAL 2014:501738

    Article  PubMed  PubMed Central  Google Scholar 

  18. Wolf-Magele A, Schnabl J, Edlinger S, Pok SM, Schoerg P, Sprinzl GM (2015) Postoperative changes in telemetry measurements after cochlear implantation and its impact on early activation. Clin Otolaryngol 40(6):527–534

    Article  CAS  PubMed  Google Scholar 

  19. Prager JD, Neidich MJ, Perkins JN, Meinzen-Derr J, Greinwald JH Jr (2012) Minimal access and standard cochlear implantation: a comparative study. Int J Pediatr Otorhinolaryngol 76(8):1102–1106

    Article  PubMed  Google Scholar 

  20. Stolle S, Groß S, Lenarz T, Lesinski-Schiedat A (2014) Postoperative Früh- und Spätkomplikationen bei Kindern und Erwachsenen nach CI-Implantation. Laryngorhinootologie 93:605–611

    Article  CAS  PubMed  Google Scholar 

  21. Stratigouleas ED, Perry BP, King SM, Syms CA 3rd (2006) Complication rate of minimally invasive cochlear implantation. Otolaryngol–Head Neck Surg 135(3):383–386

    Article  PubMed  Google Scholar 

  22. Chen JK, Hu HC, Kuo CL, Li LP (2016) “Rounded Insertion”: a useful cochlear implantation technique for patients with cochlear hypoplasia type I. Otolaryngol–Head Neck Surg 154(4):771–772

    Article  PubMed  Google Scholar 

  23. Chen JK, Chuang AY, Sprinzl GM, Tung TH, Li LP (2015) Safety and feasibility of initial frequency mapping within 24 hours after cochlear implantation. Acta Otolaryngol 135(6):592–597

    Article  PubMed  Google Scholar 

  24. Chen JK, Chuang AY, Sprinzl GM, Tung TH, Li LP (2013) Impedance and electrically evoked compound action potential (ECAP) drop within 24 hours after cochlear implantation. PLoS ONE 8(8):e71929

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Cohen NL, Hoffman RA (1991) Complications of cochlear implant surgery in adults and children. Ann Otol Rhinol Laryngol 100(9 Pt 1):708–711

    Article  CAS  PubMed  Google Scholar 

  26. Roux-Vaillard S, Pineau A, Laccourreye L, Boucher S (2020) Immediate activation after cochlear implantation: preliminary Study. Eur Ann Otorhinolaryngol Head Neck Dis 137(1):17–20

    Article  CAS  PubMed  Google Scholar 

  27. Sunwoo W, Jeon HW, Choi BY (2021) Effect of initial switch-on within 24 hours of cochlear implantation using slim modiolar electrodes. Sci Rep 11:22809

  28. Alhabib SF, Abdelsamad Y, Yousef M, Alzhrani F, Hagr A (2021) Effect of early activation of cochlear implant on electrode impedance in pediatric population. Int J Pediatr Otorhinolaryngol 140:110543

    Article  PubMed  Google Scholar 

  29. Batuk MO, Yarali M, Cinar BC, Kocabay AP, Bajin MD, Sennaroglu G et al (2019) Is early cochlear implant device activation safe for all on-the-ear and off-the-ear sound processors? Audiol Neurootol 24(6):279–284

    Article  PubMed  Google Scholar 

  30. Hu H-C, Chen JKC, Tsai C-M, Chen H-Y, Tung T-H, Li L (2017) Evolution of impedance field telemetry after one day of activation in cochlear implant recipients. PLoS ONE 12:e0173367

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Saoji AA, Adkins WJ, Graham MK, Carlson ML (2022) Does early activation within hours after cochlear implant surgery influence electrode impedances? Int J Audiol 61(6):520–525

  32. Hu HC, Chen JK, Li LP, Chen WK, Huang MJ, Yeh CH et al (2020) Evolution of impedance values in two different electrode array designs following activation of cochlear implants 1 day after surgery: a study of 58 patients. Clin Otolaryngol 45(4):584–590

    Article  PubMed  Google Scholar 

  33. Lin DP, Chen JK, Tung TH, Li LP (2019) Differences in the impedance of cochlear implant devices within 24 hours of their implantation. PLoS ONE 14(9):e0222711

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Wei JJ, Tung TH, Li LP (2021) Evolution of impedance values in cochlear implant patients after early switch-on. PLoS ONE 16(2):e0246545

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Bruschke S, Baumann U, Stöver T (2021) Long-term follow-up of early cochlear implant device activation. audiol Neurotol 26(5):327–337

    Article  Google Scholar 

  36. Günther S, Baumann U, Stöver T (2018) Early Fitting in Cochlear Implantation: Benefits and Limits. Otol Neurotol 39(4):e250–e256

    Article  PubMed  Google Scholar 

  37. Hajr EA, Almuhawas F (2019) Financial benefits of the early fitting of a cochlear implant speech processor: assessment of the direct cost. Cureus 11(9):e5684

    PubMed  PubMed Central  Google Scholar 

  38. Fayed EA, Zaghloul HS, Morgan AE (2020) Electrode impedance changes over time in MED El cochlear implant children recipients: relation to stimulation levels and behavioral measures. Cochlear Implants Int 21(4):192–197

    Article  PubMed  Google Scholar 

  39. Paasche G, Tasche C, Stöver T, Lesinski-Schiedat A, Lenarz T (2009) The long-term effects of modified electrode surfaces and intracochlear corticosteroids on postoperative impedances in cochlear implant patients. Otol Neurotol 30(5):592–598

    Article  PubMed  Google Scholar 

  40. Wolfe J, Baker RS, Wood M (2013) Clinical case study review: steroid-responsive change in electrode impedance. Otol Neurotol 34(2):227–232

    Article  PubMed  Google Scholar 

  41. Dorman MF, Smith LM, Dankowski K, McCandless G, Parkin JL (1992) Long-term measures of electrode impedance and auditory thresholds for the Ineraid cochlear implant. J Speech Hear Res 35(5):1126–1130

    Article  CAS  PubMed  Google Scholar 

  42. Busby PA, Plant KL, Whitford LA (2002) Electrode impedance in adults and children using the Nucleus 24 cochlear implant system. Cochlear Implants Int 3(2):87–103

    Article  CAS  PubMed  Google Scholar 

  43. Choi J, Payne MR, Campbell LJ, Bester CW, Newbold C, Eastwood H et al (2017) Electrode impedance fluctuations as a biomarker for inner ear pathology after cochlear implantation. Otol Neurotol 38(10):1433–1439

    Article  PubMed  Google Scholar 

  44. Cohen NL, Hoffman RA, Stroschein M (1988) Medical or surgical complications related to the Nucleus multichannel cochlear implant. Ann Otol Rhinol Laryngol Suppl 135:8–13

    Article  CAS  PubMed  Google Scholar 

  45. Gibson WP, Harrison HC, Prowse C (1995) A new incision for placement of cochlear implants. J Laryngol Otol 109(9):821–825

    Article  CAS  PubMed  Google Scholar 

  46. Mangus B, Rivas A, Tsai BS, Haynes DS, Roland JT (2012) Surgical techniques in cochlear implants. Otolaryngol Clin N Am 45(1):69–80

    Article  Google Scholar 

  47. Bond M, Mealing S, Anderson R, Elston J, Weiner G, Taylor RS et al (2009) The effectiveness and cost-effectiveness of cochlear implants for severe to profound deafness in children and adults: a systematic review and economic model. Health Technol Assess (Winchester, England) 13(44):1–330

    Google Scholar 

  48. Ciorba A, Bovo R, Trevisi P, Rosignoli M, Aimoni C, Castiglione A et al (2012) Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases. Eur Arch Oto-rhino-laryngol 269(6):1599–1603

    Article  CAS  Google Scholar 

Download references

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Jouf University, PO Box 72418, Skaka, 23235, Saudi Arabia

    Afrah Alshalan

  2. Research Department, MED-EL GmbH, Riyadh, Saudi Arabia

    Yassin Abdelsamad

  3. King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Medhat Yousef, Asma Alahmadi, Fida Almuhawas & Abdulrahman Hagr

  4. Audiology Unit, ENT Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

    Medhat Yousef

Authors
  1. Afrah Alshalan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yassin Abdelsamad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Medhat Yousef
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Asma Alahmadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fida Almuhawas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdulrahman Hagr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Afrah Alshalan.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare, including any financial, personal, or other relationships with other people or organizations known or identified. In addition, we confirm that all authors have approved this manuscript in its current version, and all of the copyright will be transferred to the European Archives of Oto-Rhino-Laryngology journal in case of acceptance.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alshalan, A., Abdelsamad, Y., Yousef, M. et al. Early activation after cochlear implantation: a systematic review. Eur Arch Otorhinolaryngol 280, 3489–3502 (2023). https://doi.org/10.1007/s00405-023-07965-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-023-07965-3

Keywords

Search

Navigation