[Direction of cochlear implant developments used for the correction of perimodiolar discrimination location]

Introduction: Cochlear implant is a hearing enhancement device that directly stimulates nerve cells with electrical impulses. The optimal placement of the implanted electrode array is crucial for device wearers. Numerous domestic and international studies have confirmed a significant correlation between the quality of restored electrical hearing after surgery. During optimal implantation, electrodes are placed as close as possible to the spiral ganglion cells, allowing for more focused stimulation to improve speech perception and speech intelligibility. Objective: Our aim is to investigate the positioning of the electrode array and optimize the smallest distance to the cochlear midline. Additionally, we analyze the favourable position virtually and digitally redesign the shape of the inserted electrodes. Method: For our research, we analyzed the positioning results of 10 perimodiolar implanted electrode arrays. The results of intraoperative imaging procedures were compared with electrophysiological methods (impedance, neural response telemetry examination). Results: Based on our measurements, we compared virtually created electrode arrays with differentially deformed basal segments (0°, 15°, 30° and 45°). Electrophysiological and imaging techniques confirm that the electrode array is in a more favourable position when it is closer to the cochlear midline. Conclusion: The repositioning of the reshaped electrode array can have a drastic impact on future speech perception, speech quality, and device energy consumption. Orv Hetil. 2024; 165(37): 1452–1460.