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Updated: Feb 12, 2026

Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
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Incidence of Trans-Impedance Matrix Pattern Variants in Patients With Normal Anatomy Receiving Cochlear Implantation.

Justin Cottrell1, Christine Schremp2, Arianna Winchester2

  • 1Division of Otolaryngology-Head and Neck Surgery, Yale University, CT.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|February 11, 2026
PubMed
Summary
This summary is machine-generated.

Transimpedance (TIM) heatmap patterns were assessed in cochlear implant (CI) patients. A lower incidence of TIM heatmap variants was observed in patients with normal cochlear anatomy undergoing primary implantation.

Keywords:
Cochlear implantCochlear implant placementPlacement confirmationTrans-impedance matrix

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Neurosurgery

Background:

  • Transimpedance (TIM) heatmap patterns can indicate cochlear implant electrode integrity.
  • Understanding TIM pattern variants is crucial for assessing cochlear implant outcomes.

Purpose of the Study:

  • To apply a transimpedance (TIM) heatmap classification scheme in patients with normal cochlear anatomy and in revision cochlear implant (CI) cases.
  • To determine the incidence of TIM pattern variants and their clinical implications in these cohorts.

Main Methods:

  • A single-center retrospective review of 321 cochlear implantations (CI) between June 2020 and June 2024.
  • TIM heatmap patterns were analyzed intraoperatively in patients with normal cochlear anatomy and in a separate cohort undergoing revision surgery.
  • TIM patterns were correlated with intraoperative X-ray findings of electrode position.

Main Results:

  • Of 321 implants, 310 were primary surgeries and 11 were revision surgeries.
  • 86.4% of primary CI surgeries showed normal TIM heatmaps, while only 45.5% of revision surgeries did.
  • One revision case presented a novel 'double X' TIM pattern, which corresponded to a normal electrode position.

Conclusions:

  • A decreased incidence of transimpedance (TIM) heatmap pattern variants occurs in cochlear implant (CI) recipients with normal cochlear anatomy.
  • TIM heatmap analysis may offer insights into electrode function, particularly in revision CI scenarios.