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Impact of Cochlear Implant Array Placement on Speech Perception

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Abstract

Purpose

To assess the role of flat panel computed tomography (FPCT) in the evaluation of cochlear implant (CI) electrode position and its relation to speech perception.

Methods

From March 2015 to March 2019, we retrospectively enrolled deaf subjects ≥ 18 years who underwent unilateral CI by one surgeon, imaged with FPCT and assessed with disyllabic words score before CI and at 6 months of follow-up. We calculated the disyllabic score difference before CI and after CI (ΔSDS) and divided the subjects in favorable and unfavorable outcome groups using the median ΔSDS as a cutoff. We compared the demographic, clinical, electrode characteristics, and the CI positioning variables scalar position, surgical insertion depth (SID), linear insertion depth (LID), angular insertion depth (AID) and wrapping factor (WF).

Results

We studied 50 subjects (F/M = 27/23; median age = 60.5 years, IQR: 50–70 years). The median ΔSDS was 80% (interquartile range [IQR]: 60–100%) in quiet and 80% (IQR: 47.5–100%) in noise. Of the subjects 23 demonstrated a favorable outcome and had earlier age at CI (median 52 years; IQR 45–67 years versus median 62 years; IQR: 56–71 years p = 0.032) and a significantly higher SID (median: 4.02 mm IQR: 3.00–5.35 mm versus median: 2.94 mm IQR: 2.06–3.90 mm; p = 0.029). No difference was found for LID (p = 0.977), AID (p = 0.302), and WF (p = 0.224). A logistic regression model built with the age at CI, number of CI electrodes, and the SID was significant χ2 ((df = 3, N = 50) = 14.517, p = 0.002). The model explained 33.7% (Nagelkerke R2) of ΔSDS variance and correctly classified 76% of the cases.

Conclusion

The SID measured by FPCT predicts the ΔSDS at 6 months follow-up, alongside with age at implantation and number of CI electrodes.

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Abbreviations

AID:

Angular insertion depth

CI:

Cochlear implant

ΔSDS:

Disyllabic word score difference at 6‑months follow-up after surgery

ERW:

Extended round window approach

FPCT:

Flat panel computed tomography

LID:

Linear insertion depth

MDCT:

Multi-detector computed tomography

PTA:

Pure tone average

RW:

Round window

SID:

Surgical insertion depth

SSHL:

Sensorineural hearing loss

ST:

Scala tympani

SV:

Scala vestibuli

WF:

Wrapping factor

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Authors and Affiliations

  1. Department of Neuroradiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via Francesco Sforza, 28, 20122, Milan, Italy

    Francesco Lo Russo, Giorgio Conte, Silvia Casale, Luca Caschera, Luciano Lombardi & Fabio Triulzi

  2. Audiology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

    Federica Di Berardino, Sara Cavicchiolo & Diego Zanetti

  3. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy

    Fabio Triulzi

Authors
  1. Francesco Lo Russo
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  2. Giorgio Conte
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  3. Federica Di Berardino
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  4. Sara Cavicchiolo
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Corresponding author

Correspondence to Francesco Lo Russo.

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Conflict of interest

F. Lo Russo, G. Conte, F. Di Berardino, S. Cavicchiolo, S. Casale, L. Caschera, L. Lombardi, F. Triulzi and D. Zanetti declare that they have no competing interests.

Ethical standards

This observational retrospective study was conducted under the research protocols (ID numbers 468_2018bis 2nd Jan 2019) approved by the Institutional Review Board (IRB) of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico.

Supplementary Information

62_2021_1046_MOESM1_ESM.tiff

Online resource 1: (a–d) Bland Altman chart for evaluation of interrater reliability of measurements of surgical insertion depth (SID) (a), linear insertion depth (LID) (b), angular insertion depth (AID) (c), and wrapping factor (WF) (d). The two dashed lines correspond to the upper and lower limits of agreement for each measurement estimated (according to the Bland Altman method). The vertical axis represents the differences between the first and the second operator measurements for each metric. The horizontal axis represents the mean of estimation of first and the second operator measurements for each metric.

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Lo Russo, F., Conte, G., Di Berardino, F. et al. Impact of Cochlear Implant Array Placement on Speech Perception. Clin Neuroradiol 32, 175–183 (2022). https://doi.org/10.1007/s00062-021-01046-w

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