TY - JOUR
T1 - Evaluation of Outcome Variability Associated With Lateral Wall, Mid-scalar, and Perimodiolar Electrode Arrays When Controlling for Preoperative Patient Characteristics
AU - Fabie, Joshua E.
AU - Keller, Robert G.
AU - Hatch, Jonathan L.
AU - Holcomb, Meredith A.
AU - Camposeo, Elizabeth L.
AU - Lambert, Paul R.
AU - Meyer, Ted A.
AU - McRackan, Theodore R.
N1 - Funding Information:
Address correspondence and reprint requests to Theodore R. McRackan, M.D., M.S.C.R., Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425-5500; E-mail: [email protected] This publication was supported by a K12 award through the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, NIH/ NCATS Grant Number UL1TR001450, and a grant from the Doris Duke Foundation.
Publisher Copyright:
© 2018, Otology & Neurotology, Inc.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - OBJECTIVE: Determine the impact of electrode array selection on audiometric performance when controlling for baseline patient characteristics. STUDY DESIGN: Retrospective evaluation of a prospective cochlear implant (CI) database (January 1, 2012-May 31, 2017). SETTING: Tertiary Care University Hospital. PATIENTS: Three hundred twenty-eight adult CI recipients. INTERVENTIONS/MAIN OUTCOMES MEASURED: Hearing outcomes were measured through unaided/aided pure tone thresholds and speech recognition testing before and after cochlear implantation. All reported postoperative results were performed at least 6 months after CI activation. All device manufacturers were represented. RESULTS: Of the 328 patients, 234 received lateral wall (LW) arrays, 46 received perimodiolar (PM) arrays, and 48 received mid-scalar (MS) arrays. Patients receiving PM arrays had significantly poorer preoperative earphone and aided PTAs and SRTs, and aided Consonant-Nucleus-Consonant(CNC) word and AzBio +10 SNR scores compared with patients receiving LW arrays (all p ≤ 0.04), and poorer PTAs and AzBio +10 SNR scores compared with MS recipients (all p ≤ 0.02). No preoperative audiological variables were found to significantly differ between MS and LW patients. After controlling for preoperative residual hearing and speech recognition ability in a hierarchical multiple regression analysis, no statistically significant difference in audiological outcomes was detected (CNC words, AzBio quiet, or AzBio +10 SNR) among the three electrode array types (all p > 0.05). CONCLUSION: While previous studies have demonstrated superior postoperative speech recognition scores in LW electrode array recipients, these differences lose significance when controlling for baseline hearing and speech recognition ability. These data demonstrate the proclivity for implanting individuals with greater residual hearing with LW electrodes and its impact on postoperative results.
AB - OBJECTIVE: Determine the impact of electrode array selection on audiometric performance when controlling for baseline patient characteristics. STUDY DESIGN: Retrospective evaluation of a prospective cochlear implant (CI) database (January 1, 2012-May 31, 2017). SETTING: Tertiary Care University Hospital. PATIENTS: Three hundred twenty-eight adult CI recipients. INTERVENTIONS/MAIN OUTCOMES MEASURED: Hearing outcomes were measured through unaided/aided pure tone thresholds and speech recognition testing before and after cochlear implantation. All reported postoperative results were performed at least 6 months after CI activation. All device manufacturers were represented. RESULTS: Of the 328 patients, 234 received lateral wall (LW) arrays, 46 received perimodiolar (PM) arrays, and 48 received mid-scalar (MS) arrays. Patients receiving PM arrays had significantly poorer preoperative earphone and aided PTAs and SRTs, and aided Consonant-Nucleus-Consonant(CNC) word and AzBio +10 SNR scores compared with patients receiving LW arrays (all p ≤ 0.04), and poorer PTAs and AzBio +10 SNR scores compared with MS recipients (all p ≤ 0.02). No preoperative audiological variables were found to significantly differ between MS and LW patients. After controlling for preoperative residual hearing and speech recognition ability in a hierarchical multiple regression analysis, no statistically significant difference in audiological outcomes was detected (CNC words, AzBio quiet, or AzBio +10 SNR) among the three electrode array types (all p > 0.05). CONCLUSION: While previous studies have demonstrated superior postoperative speech recognition scores in LW electrode array recipients, these differences lose significance when controlling for baseline hearing and speech recognition ability. These data demonstrate the proclivity for implanting individuals with greater residual hearing with LW electrodes and its impact on postoperative results.
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U2 - 10.1097/MAO.0000000000001951
DO - 10.1097/MAO.0000000000001951
M3 - Article
C2 - 30106854
AN - SCOPUS:85056492739
SN - 1531-7129
VL - 39
SP - 1122
EP - 1128
JO - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
IS - 9
ER -