Otology & Neurotology最新文献

{"title":"Active Middle Ear Implantation for Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.","authors":"Udi Shapira, Tal Lifshitz, Nidal Muhanna, Omer J Ungar","doi":"10.1097/MAO.0000000000005081","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005081","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the audiological outcomes and safety profile of the Vibrant Soundbridge middle ear implant in patients with moderate-to-severe sensorineural hearing loss. Databases reviewed: PubMed, Embase, Google Scholar, and the enrolled papers' reference lists.</p><p><strong>Methods: </strong>A systematic literature review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The database search yielded 194 articles, of which 48 underwent full-text review. The extracted data included age, sex, length of follow-up period and functional hearing gain.</p><p><strong>Results: </strong>Twenty-three studies (917 ears) were included in the qualitative synthesis, of which 16 (648 ears) were suitable for quantitative meta-analysis. The mean (SD) preoperative pure-tone average was 56.69 (4.27) dB hearing level. The pooled mean functional gain was 24.29 dB (95% CI: 20.09-28.49; P<0.01) hearing level. There was high interstudy heterogeneity (I²=99%). The overall complication rate over a mean follow-up period of 23.2 months was 8.3%, and the revision surgery rate over the same follow-up period was 6.2%. Internal device failure occurred in 1.7% (n=7/413) cases.</p><p><strong>Conclusion: </strong>The Vibrant Soundbridge provided significant functional hearing gain and demonstrated a favorable safety profile in patients with moderate-to-severe sensorineural hearing loss. It affords a promising alternative for individuals who do not benefit from conventional hearing aids.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging Detection of Secondary Endolymphatic Hydrops in a DFNA9 Patient With Sudden Deafness.","authors":"Anja Bernaerts, Jaouad Abari, Eveline Dieleman, Cathérine Blaivie, Floris L Wuyts, Joost van Dinther, Andrzej Zarowski, Bert De Foer","doi":"10.1097/MAO.0000000000004971","DOIUrl":"10.1097/MAO.0000000000004971","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1119-e1121"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Histopathologic Correlates of Cochlear Hypoplasia Type II Versus Incomplete Partition Type II.","authors":"Chloe Swords, Christopher Giardina, MengYu Zhu, Cecilia Brassett, Manohar Bance, Alicia M Quesnel","doi":"10.1097/MAO.0000000000005023","DOIUrl":"10.1097/MAO.0000000000005023","url":null,"abstract":"<p><strong>Hypothesis: </strong>Cochlear hypoplasia type-II (CH-II) and incomplete partition type-II (IP-II) may display measurable differences in modiolar: cochlear area ratios and interscalar ridge angles correlating with spiral ganglion neuron (SGN) counts.</p><p><strong>Background: </strong>Inner ear malformations (IEM) can cause variable sensorineural hearing loss and cochlear implant outcomes. CH-II and IP-II share overlapping imaging features. Subtle differences in bony cochlear architecture may underlie distinct SGN patterns.</p><p><strong>Methods: </strong>IP-II (n=11), CH-II (n=5), and normal controls (n=16) were identified from a digitised human temporal bone histologic collection. Radiologically relevant assessments of midmodiolar 2-dimensional (2D) morphology, including interscalar ridge angles and modiolar: cochlear area ratio, were compared with controls. SGNs were quantified. Digital 3-dimensional (3D) reconstructions were created to appreciate the difference in anatomy further.</p><p><strong>Results: </strong>On midmodiolar sections, interscalar septum deficiency, indicating fusion of perilymph-containing scalae, occurred between upper basal and upper middle turns (CH-II, IP-II) and lower middle and apical turns (IP-II only) of the cochlea. Compared with normal cochleae, both CH-II and IP-II cases had a smaller modiolar: cochlear area ratio ( P <0.01), and flattened interscalar ridge angles (attachment of interscalar septum to inner cochlea lumen; P <0.01). In CH-II, SGN counts were markedly reduced, ranging from 0% to 20% (mean 8%) of SGN counts in age-matched normally formed cochleae (normal hearing ears); IP-II ranged from 5% to 95% (mean 57%) of age-matched normal cochleae.</p><p><strong>Conclusions: </strong>Given the reduced SGN counts in CH-II compared with normal and IP-II, accurate radiologic subclassification of CH-II versus IP-II is necessary to optimise candidacy selection and counselling for cochlear implantation. A predictive algorithm is suggested based on histologic criteria that might help distinguish between IP-II and CH-II cochleae.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1174-1182"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spoken Language Outcomes After Early Cochlear Implantation in a Diverse, Multi-Institutional Cohort of Congenitally Deaf Children.","authors":"Evan J Patel, Jihyun Stephans, Patricia Yoon, Alexander Cherches, Eunsaem Cho, Samantha Anne, Hana Rosen, Daniela Carvalho, Sasha Shenk, Kendyl Naugle, Laura Covello, Lisa McWilliams, Julie Cooper, Cathleen Mathes, Bridget Klaus, Cedric Pritchett, Pascal Escobar, Jason Park, Kalpnaben Patel, Jennifer Hoffman, Jourdan Holder, David Haynes, Frank Virgin, Dylan K Chan","doi":"10.1097/MAO.0000000000004998","DOIUrl":"10.1097/MAO.0000000000004998","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate spoken language outcomes in a diverse, multi-institutional cohort of children with severe-to-profound hearing loss who have undergone cochlear implantation (CI).</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Multi-institutional study at 9 cochlear implant centers and schools with data from 2017 to 2025.</p><p><strong>Patients: </strong>Children with bilateral congenital severe-to-profound SNHL who underwent CI before 24 months of age.</p><p><strong>Interventions: </strong>Cochlear implantation.</p><p><strong>Main outcome measures: </strong>Standardized, age-normed language assessments [Preschool Language Scales (PLS) and Receptive-Expressive Emergent Language (REEL)]. Sociodemographic status was assessed using the Social Vulnerability Index (SVI), a validated, national geocoded measure based on residential home address.</p><p><strong>Results: </strong>One hundred forty patients identified at 9 separate institutions were included. The mean SVI was 0.493 ( SD =0.274; range: 0.011 to 0.973). The majority of patients (57.9%, 81 patients) were implanted before 12 months (early CI), while 42.1% (59 patients) were implanted from 12 to 24 months (late CI). At age 3, the mean total language score for the early CI group was higher than that of the late CI group (94.0 vs. 73.4, P <0.001). In a sub-analysis of the early CI cohort, total language was higher in babies implanted before 9 months compared with those implanted before 12 months (100.2 vs. 88.5, P <0.001). SVI was not associated with age at implantation ( P =0.10). On multivariable regression, SVI and age at CI were associated with total language scores.</p><p><strong>Conclusions: </strong>Earlier cochlear implantation, particularly before 9 months of age, is associated with significantly improved spoken language outcomes in a diverse cohort of infants with congenital bilateral severe-to-profound hearing loss.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1131-1136"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of the 10% Electroneurography Threshold on Complete Recovery in Pediatric Bell's Palsy: A Hazard Ratio Analysis.","authors":"Shintaro Baba, Ai Yoshitomi, Ryosuke Sugito, Kenji Kondo","doi":"10.1097/MAO.0000000000005013","DOIUrl":"10.1097/MAO.0000000000005013","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the ability of the 10% electroneurography (ENoG) threshold to predict complete recovery (House-Brackmann [H-B] grade I without sequelae) in pediatric Bell's palsy.</p><p><strong>Methods: </strong>This retrospective study included 27 pediatric patients aged 0 to 12 years with Bell's palsy who underwent ENoG between 8 days and 3 weeks after onset. All the patients received corticosteroid therapy (prednisolone ≥1 mg/kg/day), with severe cases receiving a high-dose regimen (2-4 mg/kg/day). The primary endpoint was complete recovery, defined as H-B grade I with no pathologic synkinesis or facial contracture. Recovery profiles were compared between a high-ENoG group (ENoG ≥10% residual amplitude, n=13) and a low-ENoG group (ENoG <10% residual amplitude, n=14) over a 12-month, follow-up period.</p><p><strong>Results: </strong>All the patients (100%) attained at least H-B grade II. The high-ENoG group had a 100% complete recovery rate within 3 months, whereas the low-ENoG group had a 50% complete recovery rate and a significantly longer time course. Log-rank analysis demonstrated a significant difference in the recovery curve ( P <0.001). Receiver operating characteristic curve analysis confirmed that the 10% threshold was optimal for predicting complete recovery (area under the curve: 0.804; 100% specificity for predicting complete recovery). Cox regression analysis identified ENoG ≥ 10% residual amplitude as the most accurate predictor of complete recovery (hazard ratio: 9.61; 95% CI: 2.64-34.89; P <0.001).</p><p><strong>Conclusion: </strong>While pediatric Bell's palsy had an excellent overall prognosis in terms of functional improvement (H-B grade II), the ENoG 10% threshold was the best predictor of complete recovery without permanent sequelae.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1159-1165"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Loading of a Percutaneous Bone-Anchored Hearing Implant System Following Single-Stage Surgery in Children: A Prospective 2-Year Study.","authors":"Ayla Tabaksert, Lisa Kennedy, Diana Lynch, Kia N Iversen, Anirvan Banerjee","doi":"10.1097/MAO.0000000000004988","DOIUrl":"10.1097/MAO.0000000000004988","url":null,"abstract":"<p><strong>Objective: </strong>To assess implant stability, safety, and functional outcomes of early sound processor activation following single-stage bone-anchored hearing implant (BAHI) surgery with a percutaneous implant system in a pediatric population.</p><p><strong>Study design: </strong>Prospective single-center, single-armed, observational study with 24-month follow-up.</p><p><strong>Setting: </strong>University hospital clinic.</p><p><strong>Patients: </strong>Fifteen pediatric patients (aged 7 to 14 y), who had used a sound processor on a softband for at least 2 weeks before surgery, including one bilaterally implanted patient, leading to a total number of 16 implants.</p><p><strong>Intervention: </strong>Early sound processor loading following single-stage BAHI surgery.</p><p><strong>Main outcome measures: </strong>Implant stability, assessed by the implant stability quotient (ISQ). Secondary outcomes included implant survival, audiological performance, soft tissue tolerance (Holgers score), and patient-reported outcomes.</p><p><strong>Results: </strong>ISQ showed a high degree of implant stability already at surgery, and numerical increases over time in combination with a 100% implant survival over 24 months showed good osseointegration. Fifty percent of the implant sites were reported to have no skin reactions throughout the 24-month follow-up period. The remaining had a maximum Holgers score of 1 (minor skin reaction), and a single implant site was reported to have an adverse skin reaction (Holgers 2). None of the skin reactions were persistent or were reported to interfere with sound processor use. Postoperative audiological assessment showed improvement in hearing thresholds when comparing the implanted solution to the softband.</p><p><strong>Conclusion: </strong>Single-stage BAHI surgery, followed by early loading of the percutaneous implant, is safe and feasible in children.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1071-1078"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Results and Timing of Cochlear Implantation in Patients With DFNA9 (p.Pro51Ser).","authors":"Sybren M M Robijn, Josephine W I van Nierop, Wendy J Huinck, Emmanuel A M Mylanus, Henricus P M Kunst, Cornelis P Lanting, Ronald J E Pennings","doi":"10.1097/MAO.0000000000004969","DOIUrl":"10.1097/MAO.0000000000004969","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate long-term outcomes of cochlear implantation (CI) in DFNA9 patients with the p.Pro51Ser COCH variant, compared with matched controls, and to identify clinical predictors of performance and quality of life (QoL).</p><p><strong>Background: </strong>DFNA9, caused by pathogenic variants in the COCH gene, is a progressive hereditary hearing loss with variable vestibular dysfunction that often necessitates cochlear implantation.</p><p><strong>Methods: </strong>In this retrospective cohort study, 56 DFNA9 patients were compared with case-matched postlingually deaf CI recipients without hereditary hearing loss. Speech perception, pure-tone thresholds, and QoL (Nijmegen Cochlear Implant Questionnaire, Glasgow Benefit Inventory) were assessed preimplantation and at 6 weeks, 1 year, and 5 years. Linear and mixed-effects models were applied to identify predictors and longitudinal changes.</p><p><strong>Results: </strong>Cochlear implantation significantly improved speech perception and QoL in both groups, with no differences between DFNA9 and controls and stable performance up to 5 years. Postoperative residual hearing (PTA₀.₅-2 kHz) was a significant predictor of 1-year speech perception. In DFNA9, higher preoperative aided speech perception was more strongly associated with postoperative outcomes, underscoring the advantage of implantation before further decline. Speech perception scores predicted QoL, although the link with perceived social benefit was weaker in DFNA9 than in controls.</p><p><strong>Conclusions: </strong>CI provides durable, noninferior outcomes in DFNA9 patients compared with controls. Although the study did not examine the impact of hearing loss severity or rate of decline, the excellent outcomes observed in this cohort may help clinicians to consider earlier implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1072-e1079"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Sinus Stenting for Pulsatile Tinnitus: A Systematic Review and Meta-Analysis.","authors":"Sevda Alipour Khabir, Julien Ognard, Gerard El Hajj, Natália Vasconcellos De Oliveira Souza, Owen Heidtke, Tor Lindell, Esref Bayraktar, Cem Bilgin, Sherief Ghozy, Ramanathan Kadirvel, David F Kallmes, Waleed Brinjikji","doi":"10.1097/MAO.0000000000005016","DOIUrl":"10.1097/MAO.0000000000005016","url":null,"abstract":"<p><strong>Background: </strong>Pulsatile tinnitus (PT) is frequently caused by venous sinus stenosis and may be associated with idiopathic intracranial hypertension (IIH). Venous sinus stenting (VSS) directly addresses venous outflow obstruction and has emerged as a therapeutic option; however, outcome data remain heterogeneous. We performed an updated systematic review and meta-analysis to evaluate the efficacy and durability of VSS for PT and to compare outcomes between IIH-associated and isolated PT.</p><p><strong>Methods: </strong>MEDLINE, Scopus, and Web of Science were searched from inception through December 2025 following PRISMA guidelines. Clinical studies reporting PT outcomes after VSS were included. Random-effects meta-analyses of proportions were conducted to estimate pooled rates of overall improvement, complete resolution, and recurrence. Prespecified subgroup analyses compared IIH versus isolated PT.</p><p><strong>Results: </strong>Thirty-two studies comprising 850 patients were included (641 with IIH; 209 with isolated PT). Venous sinus stenosis accounted for 90.3% of treated etiologies. The pooled rate of overall PT improvement was 89.8% (95% CI, 85.5-92.9). Complete resolution occurred in 87.1% (95% CI, 82.5-90.6). Recurrence at last follow-up was 10.9% (95% CI, 8.3-14.2). Improvement and complete resolution rates did not differ significantly between IIH and isolated PT. Recurrence was higher in IIH (12.0%) than in isolated PT (5.7%), without reaching statistical significance.</p><p><strong>Conclusions: </strong>VSS is associated with high rates of PT improvement and complete resolution with low recurrence. Recurrence trends appear higher in IIH, suggesting underlying pathophysiology may influence durability.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1061-1070"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Intelligibility and Spectral Resolution Results in Cochlear Implant Users With and Without Inner Ear Malformations and the Effect of Angular Insertion Depth.","authors":"Merve Ozses, Betul Cicek Cinar, Levent Sennaroglu","doi":"10.1097/MAO.0000000000004996","DOIUrl":"10.1097/MAO.0000000000004996","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare speech perception in noise and spectral resolution between CI users with normal cochlea and those with inner ear malformations (IEMs) and to examine the relationship between angular insertion depth (AID).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Prospective cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Cochlear implant (CI) program at a tertiary medical center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Thirty-seven pediatric CI users participated: 14 with normal cochleae and 23 with IEMs (2 with IP-I, 15 with IP-II, 1 with IP-III, and 5 with CH-III). The normal cochleae group consisted of 3 unilateral CI users, 7 bimodal users, and 4 bilateral users, whereas the IEM group consisted of 6 unilateral CI users, 10 bimodal users, and 7 bilateral users. All participants received MED-EL devices. A total of 48 implanted ears from 37 patients were included. In the IEM group, 18 ears (1 with IP-I, 1 with CH-III, and 16 with IP-II) received the FORM24 electrode, and 10 ears (1 with IP-I, 1 with IP-II, 2 with IP-III, and 6 with CH-III) received the FORM19 electrode.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Speech perception was assessed using the hearing in noise test for children (HINT-C), and spectral resolution was measured using the Spectral-Temporally Modulated Ripple Test (SMRT). AID was determined using postoperative transorbital x-rays. Associations between AID and auditory outcomes were examined using correlation and linear mixed-effects modeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CI users with normal cochleae had better speech perception signal-to-noise ratio (SNR) in the N Ipsilateral S Front and N Front S Front conditions, whereas CI users with IEMs demonstrated poorer speech perception in noise, requiring more favorable SNRs. There was no significant difference in the N Contralateral S Front condition. CI users with IEMs had lower ripple-density thresholds, indicating reduced spectral resolution. In simple regression analyses, deeper AID was associated with better performance in the Quiet and NIpsilateralSFront conditions and with higher SMRT scores. However, in linear mixed-effects models, group differences remained significant for Quiet, N Ipsilateral S Front and N Front S Front , whereas AID independently influenced only Quiet and N Ipsilateral S Front . No independent effect of AID on SMRT was observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CI users with IEMs required higher signal-to-noise ratios to understand speech in noise and demonstrated poorer spectral resolution than their CI peers with normal cochleae. Although deeper AID was positively correlated with both spectral-resolution skills and speech perception, its independent contribution to spectral resolution appears limited after adjusting for clinical and demographic factors. These results suggest that cochlear anatomy and electrode insertions have potential clinical roles in auditory outcomes, highlighting the multifactorial nature of performance variability in","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1118-1130"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical Electrode Placement to Augment Intracochlear Current in Patients With an Ossified Cochlea and Incomplete Electrode Array Insertion.","authors":"Justin Cottrell, Emily R Spitzer, David M Landsberger, Natalia Stupak, William Shapiro, Rebecca Piper, Chris Ndoleriire, Eddie Mukaaya, Sean McMenomey, J Thomas Roland","doi":"10.1097/MAO.0000000000004970","DOIUrl":"10.1097/MAO.0000000000004970","url":null,"abstract":"<p><strong>Objective: </strong>To describe a novel surgical technique utilizing the placement of an apical ground electrode to facilitate intracochlear current modulation in patients with cochlear ossification and incomplete electrode array insertion.</p><p><strong>Patients: </strong>Patients with incomplete standard electrode array insertion due to cochlear ossification.</p><p><strong>Intervention: </strong>Standard cochlear implant (CI) electrode array insertion, in addition to the placement of the extracochlear ground electrode into the cochlear apex to enable current steering through areas of cochlear ossification and towards the cochlear apex.</p><p><strong>Main outcome measures: </strong>Procedural safety and patient-reported perceptual differences between programming configurations utilizing the apical ground.</p><p><strong>Results: </strong>Placement of an apical ground electrode was safe and feasible in 3 patients with complex ossified cochlea and was able to augment sound perception, and improve performance, after adjustments to device programming.</p><p><strong>Conclusions: </strong>Apical ground electrode placement represents a technically achievable adjunct in selected patients with ossified cochlea and incomplete electrode array insertion. This approach may expand the functional stimulation field utilizing intracochlear current modulation to improve patient performance.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1069-e1071"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}