19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO
Variability of interaural depth of insertion in children with bilateral cochlear implants
Cochlear implant electrode array angular depth of insertion (DOI) can affect speech perception outcomes. Location of the array may account for some variability in word recognition between patients likely due to the frequency-to-place mismatch in the inner ear. Furthermore, evidence from bilateral CI users suggests that asymmetrical DOI, or mismatch, can affect binaural benefit. DOI may vary between ears due to factors such as asymmetrical anatomy, differences in electrode type, or post-operative migration of the electrode array. This investigation seeks to identify the variability of mismatch, incidence of severe mismatch, and demographic or anatomic factors associated with mismatch in children with bilateral CIs.
In this prospective observational study, children with bilateral CIs underwent bilateral cochlear view x-rays for measurement of angular DOI. Exclusion criteria included non-cochlear view imaging and anatomic abnormalities. Two blinded pediatric otolaryngologists reviewed deidentified and randomized images for measurement of linear DOI defined by distance (mm) of the proximal electrode from the round window. Mean DOI difference was reported with a severe mismatch defined as a difference greater than 3mm (Goupell et al., 2013). Demographics and device information were gathered through chart review of all bilaterally implanted children from November 2017–October 2019 at our tertiary referral pediatric hospital.
Seventeen of 23 patients with bilateral CIs had adequate imaging to measure linear DOI. All patients had the same electrode array type in both ears. The majority of patients reviewed were simultaneously implanted (n=15) with normal cochlear anatomy (n=12). One patient, who was simultaneously implanted with normal cochlear anatomy, had severe mismatch with a difference of 3.1 mm between ears. The sixteen remaining participants had interaural difference in linear DOI less than or equal to 2 mm.
These results show low incidence of asymmetrical DOI. However, the data is limited by sample size and simultaneous over sequential implantation.
- Identify the variability of mismatch between bilateral cochlear implants
- Identify the incidence of severe mismatch between bilateral cochlear implants
- Identify the demographic or anatomic factors associated with mismatch
Poster:
21060_13030MoiraMcShane.pdf
Presenter: Moira McShane
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.