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Electrode impedance dynamics in sequential cochlear implant users: insights into cochlear immunity.

Logan L Flom1, Eva L Rasche2, Jacob J Oleson2

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Iowa Health Care Medical Center, Iowa City, IA, United States.

Frontiers in Immunology
|November 14, 2025
PubMed
Summary

The first cochlear implant primes the second ear, causing a stronger immune response and higher electrode impedance. This suggests immunological memory impacts sequential cochlear implant outcomes.

Keywords:
cochlear implantforeign body responsehearing loss preventionimmunological memoryimmunologyimpedanceinflammationretrospective cohort

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Area of Science:

  • Otorhinolaryngology
  • Immunology
  • Biomedical Engineering

Background:

  • Cochlear implant outcomes are limited by foreign body responses, including new bone growth and fibrosis.
  • The role of immunological memory in sequential cochlear implantation is understudied.
  • Foreign body responses can increase electrode impedance, affecting device performance.

Purpose of the Study:

  • To investigate the hypothesis that a first cochlear implant primes the contralateral ear for a more robust immune response during sequential implantation.
  • To analyze if immunological memory influences electrode impedance in sequentially implanted patients.

Main Methods:

  • Retrospective cohort analysis of clinical impedance measurements.
  • Analysis of impedance data from 79 subjects with sequential bilateral cochlear implants.
  • Comparison of impedance over time based on implant sequence using paired t-tests and linear mixed models.

Main Results:

  • Statistically significant differences in 12-month average absolute impedance between first and second implants.
  • Implant sequence, time elapsed, and electrode grouping significantly affected impedance.
  • Significant differences in impedance changes were observed between basal and apical electrode groups based on implant sequence.

Conclusions:

  • Sequential cochlear implantation elicits a more robust immune response in the second implanted ear, indicated by increased electrode impedance.
  • Findings suggest immunological memory plays a role in modulating intracochlear foreign body responses.
  • Further research on implant timing and materials is needed to optimize cochlear implant outcomes.