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Relationship Between Electrocochleography, Angular Insertion Depth, and Cochlear Implant Speech Perception Outcomes.

Michael W Canfarotta1, Brendan P O'Connell1, Christopher K Giardina1

  • 1Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina, USA.

Ear and Hearing
|December 28, 2020
PubMed
Summary
This summary is machine-generated.

Electrocochleography (ECochG) and cochlear implant (CI) array insertion depth significantly predict speech perception. Combining ECochG, insertion depth, and array design explains 72% of speech outcome variability.

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Area of Science:

  • Audiology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Electrocochleography (ECochG) measures residual cochlear function before cochlear implant (CI) insertion, explaining significant variability in adult speech perception outcomes.
  • Surgical factors, such as array insertion depth (AID) and array design, are also implicated in post-CI speech perception.
  • Prior research shows a positive correlation between AID and speech perception for straight arrays, and an inverse relationship for precurved arrays.

Purpose of the Study:

  • To determine the combined effects of ECochG, AID, and array design on speech perception outcomes in adult CI recipients.
  • To develop a predictive model for speech perception incorporating both pre-operative cochlear function and surgical parameters.

Main Methods:

  • Fifty postlingually deafened adult CI recipients were studied, receiving either straight or precurved electrode arrays.
  • Intraoperative ECochG total response (TR) and postoperative imaging for AID were measured.
  • Multiple linear regression was used to predict consonant-nucleus-consonant (CNC) word recognition at 6 months postactivation.

Main Results:

  • ECochG TR alone accounted for 43% of the variance in speech perception outcomes (p < 0.001).
  • A combined model incorporating TR, AID, and array design explained 72% of the variability in speech perception outcomes (p < 0.001).
  • The model showed a tendency to under/overestimate performance based on array type and insertion depth.

Conclusions:

  • A predictive model incorporating ECochG, AID, and array design significantly improves the prediction of speech perception outcomes compared to ECochG alone.
  • Peripheral factors, including cochlear health and electrode placement, play a crucial role in determining speech perception abilities with cochlear implants.