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Auditory outcomes after scala vestibuli array insertion are similar to those after scala tympani insertion 1 year after cochlear implantation

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

Abstract

Purpose

In cochlear implantation, a scala vestibuli (SV) insertion of an electrode array is a rare occurrence and is reported to be linked to poor hearing outcomes. Using the same electrode array, the auditory performance of patients with a complete SV location was compared with that of patients having a complete scala tympani (ST) location 1 year after implantation.

Methods

Thirty-three patients were included in this retrospective case–control study (SV, n = 12; ST, n = 21). The matching criteria were electrode array type, age at implantation, and duration of severe or profound deafness. The array location was analyzed using 3D reconstruction of postoperative CT scans. Postoperative audiological evaluation of the implanted ear was performed using pure-tone audiometry, speech recognition of monosyllabic words in quiet, and words and sentences in noise.

Results

On the preoperative CT scan, six patients in the SV group presented with both round window (RW) and ST ossification, three with RW ossification alone, and three with no RW ossification. Auditory performance did not differ between SV and ST groups 1 year after cochlear implantation. Speech recognition of words was 49 ± 7.6% and 56 ± 5.0% in quiet and 75 ± 9.5% and 66 ± 6.0% in noise in SV and ST groups, respectively.

Conclusion

ST insertion is the gold standard that allows the three cochlear scalae to preserve scalar cochlear integrity. However, 1 year after implantation, a planned or unexpected SV insertion is not detrimental to hearing outcomes, providing similar auditory performance in quiet and noise to ST insertion.

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Data Availability

The data that support the findings of this study are not publicly available due to the internal institutional policy but are available from the corresponding author upon reasonable request.

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Funding

The study was supported by research funding from Fondation Pour l’Audition (FPA CRA02), Fondation pour l’Audition (Starting Grant IDA-2020), and ANR Robocop ANR-19-CE19-0026-02.

Author information

Author notes

  1. Isabelle Mosnier and Renato Torres contributed equally to this work and shared the co-senior authorship.

Authors and Affiliations

  1. APHP/Sorbonne Université, GHU Pitié-Salpêtrière, Service ORL, Unité Fonctionnelle Implants Auditifs Et Explorations Fonctionnelles, 50-52 Boulevard Vincent Auriol, 75013, Paris, France

    Wenxi Gu, Hannah Daoudi, Ghizlene Lahlou, Olivier Sterkers, Evelyne Ferrary, Yann Nguyen, Isabelle Mosnier & Renato Torres

  2. Institut Pasteur/Université Paris Cité/Inserm, Institut de L’Audition, Technologie Et Thérapie Génique Pour La Surdité, 63 Rue de Charenton, 75012, Paris, France

    Wenxi Gu, Hannah Daoudi, Ghizlene Lahlou, Olivier Sterkers, Evelyne Ferrary, Yann Nguyen, Isabelle Mosnier & Renato Torres

  3. Department of Otolaryngology-Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Wenxi Gu

  4. Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru

    Renato Torres

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  1. Wenxi Gu
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Correspondence to Renato Torres.

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Supplementary Information

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In this video, we observe the 3D reconstruction of the post-operative CT scan showing the temporal bone surface and the transmastoid approach performed during the surgery. At 00:10, we observe the promontory, the ossicular chain, and the electrode array through the posterior tympanotomy. Moving on to 00:21, we observe the promontory from the external auditory canal. At 00:35, we observe the cochleostomy and the round window niche. Finally, at 00:45, we observe the promontory from different angles in an attempt to determine the position of the round window niche, but the round window niche was unidentifiable (M4V 17987 KB)

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Gu, W., Daoudi, H., Lahlou, G. et al. Auditory outcomes after scala vestibuli array insertion are similar to those after scala tympani insertion 1 year after cochlear implantation. Eur Arch Otorhinolaryngol 281, 155–162 (2024). https://doi.org/10.1007/s00405-023-08107-5

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