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Stimulation parameters differ between current anti-modiolar and peri-modiolar electrode arrays implanted within the same child

Published online by Cambridge University Press:  14 October 2016

M J Polonenko ,
S L Cushing ,
K A Gordon ,
B Allemang ,
S Jewell  and
B C Papsin
M J Polonenko*
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Canada
S L Cushing
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Toronto, Canada
K A Gordon
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Canada Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Toronto, Canada
B Allemang
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada
S Jewell
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada
B C Papsin
Affiliation:
Archie's Cochlear Implant Laboratory, Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, University of Toronto, Canada
*
Address for correspondence: Melissa J Polonenko, Archie's Cochlear Implant Laboratory, Department of Otolaryngology, 6th Floor Elm Wing, Room 6D08, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8 Fax: +1 416 813 5036 Phone: +1 416 813 6683 E-mail: melissa.polonenko@mail.utoronto.ca
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Abstract

Objective:

To compare stimulation parameters of peri-modiolar and anti-modiolar electrode arrays using two surgical approaches.

Methods:

Impedance, stimulation thresholds, comfortably loud current levels, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds were compared between 2 arrays implanted in the same child at 5 time points: surgery, activation/day 1, week 1, and months 1 and 3. The peri-modiolar array was implanted via cochleostomy in all children (n = 64), while the anti-modiolar array was inserted via a cochleostomy in 43 children and via the round window in 21 children.

Results:

The anti-modiolar array had significantly lower impedance, but required higher current levels to elicit thresholds, comfort, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds than the peri-modiolar array across all time points, particularly in basal electrodes (p < 0.05). The prevalence of open electrodes was similar in anti-modiolar (n = 5) and peri-modiolar (n = 3) arrays.

Conclusion:

Significant but clinically acceptable differences in stimulation parameters between peri-modiolar and anti-modiolar arrays persisted four months after surgery in children using bilateral cochlear implants. The surgical approach used to insert the anti-modiolar array had no overall effect on outcomes.

Keywords

Cochlear ImplantElectrodeElectric StimulationProsthesis Fitting
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 11 , November 2016 , pp. 1007 - 1021
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Portions of this article were presented at: the Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum annual conference, 28–31 August 2016, Bordeaux, France; the 14th Symposium on Cochlear Implants in Children, 12–13 December 2014, Nashville, Tennessee, USA; and the Society for Ear, Nose and Throat Advances in Children annual meetings, 5 December 2014, St Louis, Missouri, USA, and 6 December 2013, Long Beach, California.

Dr B C Papsin is The Journal of Laryngology & Otology 2016 Visiting Professor.

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