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Updated: Jan 9, 2026
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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
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Speech Discrimination Outcomes in Patients Implanted With Perimodiolar Versus Lateral Wall Cochlear Implant Arrays:
David Octeau1, Lacey Cantrell1, Molly Smeal2
1Department of Otolaryngology and Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, OH.
Summary
Perimodiolar (PM) electrodes showed a slight, non-clinically significant improvement in cochlear implant (CI) CNC scores compared to lateral wall (LW) electrodes. No significant difference in AzBio scores was observed between PM and LW electrodes, though older patients may benefit from PM electrodes.
Area of Science:
- Audiology
- Neurosurgery
- Biomedical Engineering
Background:
- Cochlear implantation is a key treatment for severe to profound sensorineural hearing loss.
- Electrode design, specifically perimodiolar (PM) versus lateral wall (LW), may influence hearing outcomes.
- Head-to-head comparisons are crucial for determining the optimal electrode choice.
Purpose of the Study:
- To systematically review and meta-analyze studies comparing cochlear implant outcomes between PM and LW electrodes.
- To assess the impact of electrode type on Consonant-Nucleus-Consonant (CNC) and AzBio speech perception scores.
Main Methods:
- Systematic review and meta-analysis of head-to-head comparison studies.
- Inclusion criteria defined for study selection; risk of bias assessed using ROBINS-I.
- Standard mean differences (SMD) calculated for CNC and AzBio outcomes; meta-analysis performed.
Main Results:
- Eleven studies were included; nine reported CNC results with moderate to low risk of bias.
- Meta-analysis showed a statistically significant but small improvement in CNC scores with PM electrodes (SMD = -0.21, P=0.04).
- No statistically significant difference in AzBio scores between PM and LW electrodes (SMD = -0.01, P=0.81); meta-regression suggested potential age-related AzBio benefits for PM electrodes.
Conclusions:
- A statistically significant, yet slight and not clinically significant, improvement in CNC scores was observed with PM electrodes.
- No significant difference in post-operative AzBio scores was found between PM and LW electrodes.
- Older patients may experience an age-related benefit in AzBio word understanding with PM electrodes.
