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Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type
Andrea DeFreese1, Katelyn Berg1, Jack Noble2
1Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA Otolaryngology-- Head & Neck Surgery
|December 12, 2024
Summary
Frequency-to-place mismatch impacts cochlear implant (CI) speech recognition, particularly with precurved electrode arrays. Daily device use and time since activation significantly improve outcomes for all CI users.
Area of Science:
- Otolaryngology
- Neuroscience
- Biomedical Engineering
Background:
- Speech recognition in cochlear implant (CI) users shows significant variability.
- Frequency-to-place mismatch, a discrepancy in cochlear tonotopic organization and electrode allocation, is a potential factor influencing CI outcomes.
Purpose of the Study:
- To evaluate the association between frequency-to-place mismatch and speech recognition in postlingually deafened adult CI users.
- To control for known clinical factors affecting CI-aided speech recognition outcomes.
Main Methods:
- Retrospective cohort study of 498 cochlear implants from 447 adult CI users (2016-2023).
- Consonant-Nucleus-Consonant (CNC) monosyllabic word recognition test as the primary outcome measure.
- Analysis included frequency-to-place mismatch, electrode array type, device use, and time since CI activation.
Main Results:
- Frequency-to-place mismatch negatively correlated with speech recognition, but only for precurved electrode arrays.
- For straight electrode arrays, only time since activation and daily device use correlated with improved word recognition.
- For precurved arrays, mismatch at 1500 Hz, scalar location, time since activation, and daily device use were significantly associated with improved word recognition.
Conclusions:
- Daily device use and time since CI activation are key to improved speech recognition for all CI users.
- Frequency-to-place mismatch and scalar location impact word recognition primarily in patients with precurved electrode arrays.
- Adaptation may help overcome mismatch in straight arrays, while precurved arrays may require more than just adaptation to mitigate placement factors.
