Otology & Neurotology最新文献

{"title":"Qualifying Cochlear Implant Candidates-Does it Matter How Patients Are Qualified?","authors":"David S Lee, Jacques A Herzog, Amit Walia, Miriam R Smetak, Cole Pavelchek, Nedim Durakovic, Cameron C Wick, Amanda J Ortmann, Craig A Buchman, Matthew A Shew","doi":"10.1097/MAO.0000000000004429","DOIUrl":"10.1097/MAO.0000000000004429","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate variable qualification criteria for cochlear implant (CI) recipients and 12-month speech perception outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>HERMES national database and nonoverlapping single-institution CI database.</p><p><strong>Patients: </strong>A total of 2,124 adult unilateral CI recipients categorized by qualifying status: AzBio in quiet (n = 1,239), +10 dB SNR (but not in quiet; n = 519), +5 dB SNR (but not in quiet or +10 dB SNR; n = 366); CNC ≤40% (n = 1,037), CNC 41% to 50% (n = 31), and CNC 51% to 60% (n = 20).</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Pre- and 12-month postoperative speech perception performance. Clinically significant improvement was defined as ≥15% gain.</p><p><strong>Results: </strong>Quiet qualifiers experienced improvement in all listening conditions, whereas +10 dB SNR and +5 dB SNR qualifiers only improved in their qualifying condition and implanted ear CNC. When stratified by expanded Medicare criteria (binaural AzBio ≤60% correct), patients that qualified in quiet experienced improvements regardless of qualifying threshold or background noise. However, those that qualified in noise and AzBio ≤60% experienced mixed results in quiet and limited gain in background noise. When ≤60% criteria was applied to CNC of the worse ear, ≤40% qualifiers experienced large improvements in all tested conditions, but those who qualified by 41% to 50% or 51% to 60% only demonstrated modest improvements in AzBio sentence testing.</p><p><strong>Conclusions: </strong>Quiet qualifiers improved in all testing conditions, while those qualifying in noise improved in their qualifying condition. Patients who qualified by expanded Medicare criteria (≤60%) showed improvement when qualifying with AzBio in quiet, but should be used with caution when qualifying patients in background noise or CNC due to more limited gains in performance.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"781-788"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449656","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":"Exacerbation of Preexisting Otologic Conditions After COVID-19 Infection.","authors":"Víctor de Cos, Omer Baker, Nicollette Pepin, Omid Moshtaghi, Peter R Dixon, Akihiro J Matsuoka, Jeffrey P Harris","doi":"10.1097/MAO.0000000000004492","DOIUrl":"10.1097/MAO.0000000000004492","url":null,"abstract":"<p><strong>Background: </strong>Since the height of the COVID-19 pandemic, there have been an increasing number of reports of incidence of otologic conditions after infection. We aim to investigate whether a history of otologic conditions was associated with elevated risk of similar or exacerbated symptoms after COVID-19 infection.</p><p><strong>Methods: </strong>Surveys were administered to patients 18 years or older who had tested positive via PCR testing for COVID-19 infection between January 2020 and September 2022. Incidence of otologic symptoms within the 10-day period after COVID-19 infection was compared between participants with a preexisting otologic condition and control participants.</p><p><strong>Results: </strong>Of 1,499 patients who tested positive for COVID-19, 63.2% were female, 87.5% were White, and the mean age was 58 years. Of these, 721 (48%) reported a preexisting otologic condition, with loss of hearing (25.5%) and history of dizziness (18.8%) being most highly represented among this subcohort. Of patients with a preexisting condition, 35.5% subjectively reported that they believed COVID-19 infection had worsened otologic symptoms of their condition. Univariable analysis revealed that individuals were more likely to report dizziness post-COVID-19 infection if they had a preexisting history of dizziness (29.1% versus 17.8%, p < 0.001) or preexisting history of vestibular neuritis (58.8% versus 19.5%, p < 0.001) than those who did not. Similarly, individuals with a history of vestibular migraine were more likely to report migraine symptoms after infection than those who did not (27.9% versus 7.2%, p < 0.001). Multivariable analysis revealed that preexisting history of dizziness, vestibular neuritis, vestibular migraine, and autoimmune conditions increased the odds of several otologic symptoms, although an exception was observed with decreased odds for changes in hearing in patients with preexisting history of dizziness. Younger age and female gender were associated with higher odds for various otologic symptoms after COVID-19 infection.</p><p><strong>Conclusions: </strong>These findings indicate that certain preexisting otologic conditions may be associated with a greater likelihood of exacerbation after COVID-19 infection and may help guide screening protocols for those at greatest risk.</p><p><strong>Level of evidence: </strong>III.</p><p><strong>Irb: </strong>UCSD IRB #801971.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"836-841"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037100","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":"A Multi-Institutional Analysis of Device Failures in a Recent Cochlear Implant Series.","authors":"Michael H Freeman, Nathan R Lindquist, James R Dornhoffer, Kristen L Yancey, Ankita Patro, Benjamin D Lovin, Taimur Siddiqui, Aniket A Saoji, Jourdan R Holder, Walter Kutz, Alex D Sweeney, David S Haynes, Matthew L Carlson, Marc L Bennett","doi":"10.1097/MAO.0000000000004438","DOIUrl":"10.1097/MAO.0000000000004438","url":null,"abstract":"<p><strong>Objective: </strong>To assess Advanced Bionics (AB) HiRes Ultra and Ultra 3D initial version (V1) cochlear implant electrode failures over time at four large cochlear implant programs.</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Four tertiary referral centers.</p><p><strong>Patients: </strong>Patients receiving AB HiRes Ultra and Ultra 3D initial version (V1) devices as of December 31, 2022.</p><p><strong>Main outcome measures: </strong>Failure rate, revision surgery, speech recognition scores.</p><p><strong>Results: </strong>Over a span of 7 years, 205 (42.6%) of 483 implanted V1 devices have failed. Device failure rate varied across institutions from 32 to 67%. Of the 205 detected failures, 163 (79%) have undergone revision surgery, with 94% of revisions being performed with Advanced Bionics devices. Average time from implantation to diagnosis of device failure was 2.7 ± 1.2 years. Most patients (89.8%) with available testing were matched or exceeded their best prefailure speech performance after implant revision. After revision, patients had an average CNC score improvement of 24.7 percentage points over their most recent pre-revision scores and demonstrated average datalogging of 12.7 ± 4.1 h/d at most recent evaluation.</p><p><strong>Conclusions: </strong>Comparison of patients across multiple high-volume implant centers confirms the presence of ongoing device failures. There is variability across institutions in the rate of revision surgery once a patient is diagnosed with a V1 device failure, as well as in the rate of device failure detection. Inter-institutional variability in failure rates may be explained by the variation in the routine use of electrical field imaging. Reimplantation with a new device typically results in a return to prefailure peak performance.</p><p><strong>Professional practice gap educational need: </strong>To our knowledge, a comparison of AB HiRes (V1) device failures across multiple institutions has not been conducted.</p><p><strong>Learning objective: </strong>To identify device failure rate across multiple institutions with different testing protocols.</p><p><strong>Desired result: </strong>Providers will have an improved understanding of the trajectory of device failures for HiRes (V1) devices over time.</p><p><strong>Level of evidence: </strong>Level IV-Historical cohort or case-controlled studies.</p><p><strong>Indicate irb or iacuc: </strong>IRB #230017; IRB #22-000183; IRB #STU-032018-085; IRB #H-49479.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"789-795"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586529","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":"Precision in Practice: Inter- and Intra-rater Reliability of Linear Measurements and Tumor Growth in Vestibular Schwannoma.","authors":"Ineke M J Pruijn, Jolanda Derks, Jérôme J Waterval, Mark Ter Laan, Yasin Temel, Sjoert A H Pegge, Alida A Postma, Wietske Kievit, Henricus P M Kunst","doi":"10.1097/MAO.0000000000004515","DOIUrl":"10.1097/MAO.0000000000004515","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to compare and assess the inter- and intra-rater reliability of various linear measurement techniques for vestibular schwannomas (VS) and their impact on determining tumor growth in a multidisciplinary multicenter setting.</p><p><strong>Methods: </strong>Six experts (neurosurgeons, otorhinolaryngologists, and radiologists) involved in VS management, from two tertiary referral centers, measured linear extrameatal VS tumor size parallel and perpendicular to the petrous ridge, and as maximum axial and maximum coronal diameter. Inter- and intra-rater reliability were evaluated using the intraclass correlation coefficient (ICC). The repeatability coefficient was computed for each measurement direction. Fleiss' kappa was used to determine the degree of agreement on tumor growth.</p><p><strong>Results: </strong>Reliability between raters was significantly excellent (ICC >0.9) across all measurement directions, with the highest ICC observed for measurements parallel to the petrous ridge (ICC, 0.974; 95% CI, 0.957-0.986). Good or excellent reliability was achieved in 95.8% of all intra-rater measurements, with predominantly higher ICC scores for measurements in the coronal plane. Fleiss' kappa for interrater variability of determining tumor growth was highest and substantial for measurements parallel to the petrous ridge 0.672 (95% CI, 0.546-0.799).</p><p><strong>Conclusion: </strong>Linear measurements of VS parallel to the petrous ridge yield excellent interrater reliability and the most favorable repeatability coefficient. Good to excellent intra-rater reliability across all measurement directions was observed. The most accurately defined tumor growth was obtained comparing measurements parallel to the petrous ridge. We recommend measurements parallel to the petrous ridge as the standard linear method for evaluating VS and growth.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e278-e284"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497590","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":"Implementation of Robot-Assisted Minimally Invasive Cochlear Implantation: A Feasibility Study.","authors":"Anne-Lise Fourez, Akil Kaderbay, Charles Villerabel, Julia Korchagina, Vincent Pean, Michel Mondain, Frederic Venail","doi":"10.1097/MAO.0000000000004531","DOIUrl":"10.1097/MAO.0000000000004531","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate if robot-assisted image-guided cochlear implant surgery can be used efficiently and safely in our center.</p><p><strong>Study design: </strong>Clinical prospective interventional monocentric study.</p><p><strong>Setting: </strong>The study was conducted in subjects over the age of 18 years who underwent unilateral cochlear implantation using a robotic system between September 2021 and December 2022.</p><p><strong>Patients: </strong>Subjects were included if the anatomy allowed for a safe trajectory for direct cochlear access to be planned.</p><p><strong>Intervention: </strong>Subjects underwent surgery using the robotic procedure.</p><p><strong>Main outcome measures: </strong>The ratio of successful electrode array insertions through the robotically drilled tunnel.</p><p><strong>Results: </strong>Ten subjects were included. The robot-assisted procedure was successful in nine cases (one bur failure). No case of facial palsy was observed. The mean drilling accuracy was 0.13 ± 0.08 mm (range, 0.03-0.26 mm) at the facial nerve, 0.14 ± 0.09 mm (range, 0.07-0.38 mm) at the chorda tympani, and 0.2 ± 0.12 mm (range, 0.03-0.26 mm) at the round window. In all robotically drilled cases, it was possible to insert the electrode array through the tunnel. One case required a second-turn cochleostomy due to an unexpected fibrosis of the basal turn. One case of partial electrode array insertion required conversion to standard procedure, which showed no improvement. For the remaining seven cases, the mean insertion depth was 520 ± 104 degrees (range, 378-712 degrees). The surgical time was 247 ± 37 minutes (range, 177-299 minutes).</p><p><strong>Conclusion: </strong>This study demonstrated the safety and efficiency of the direct tunnel approach.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"809-815"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151411","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":"Endoscopic Stapedectomy: Does Oval Window Packing Matter?","authors":"Maria A Mavrommatis, Jun Yun, Jennifer Ren, Sunder Gidumal, Maura K Cosetti, Enrique Perez, George B Wanna, Zachary G Schwam","doi":"10.1097/MAO.0000000000004496","DOIUrl":"10.1097/MAO.0000000000004496","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether differences in audiometric outcomes and postoperative vertigo exist among different approaches to oval window packing after endoscopic stapedectomy.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Academic tertiary care otology-neurotology practice.</p><p><strong>Patients: </strong>Patients who underwent endoscopic stapedectomy from 2017 to 2023.</p><p><strong>Interventions: </strong>Oval window reinforcement was performed with one of five techniques: lobular fat graft, promontory blood patch, both, other autologous patch, or none.</p><p><strong>Main outcome measures: </strong>Our primary outcome measures were subjective postoperative vertigo, change in air-bone gap (ABG; 250-4000 Hz), and air-conduction pure-tone average (PTA; 500/1000/2000/4000 Hz). Patient and surgical variables such as age, sex, laterality, surgeon, primary versus revision surgery, laser versus drill stapedotomy, and prosthesis type and length were secondarily investigated.</p><p><strong>Results: </strong>A total of 256 ears of 220 patients (mean age, 47.8 ± 12.9 yr) were included for analysis: 143 received promontory blood patch; 54, lobular fat graft; 10, both blood patch and fat graft; 2, temporalis fascia or tragal perichondrium; and 47, no reconstruction. There was no difference in incidence of subjective postoperative vertigo between groups at first and most recent follow-up ( p = 0.92 and p = 0.76, respectively). Average improvements in ABG and PTA were not significantly different among groups at first ( p = 0.35 and p = 0.27, respectively) and most recent audiograms ( p = 0.87 and p = 0.99, respectively). Although there were also no significant differences in percentage of patients achieving ABG closure to within 20 or 10 dB at first postoperative audiogram ( p = 0.48 and p = 0.51, respectively), blood patch yielded higher ABG closure to within 10 dB ( p = 0.048), but not within 20 dB ( p = 0.48) at second postoperative visit.</p><p><strong>Conclusions: </strong>Blood patch reconstruction may yield better long-term ABG closure compared with fat graft packing and no reconstruction alternatives to oval window reconstruction after endoscopic stapedectomy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"748-752"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036423","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":"Anatomical Considerations for Achieving Optimized Outcomes in Individualized Cochlear Implantation.","authors":"Max E Timm, Emilio Avallone, Malena Timm, Rolf B Salcher, Niels Rudnik, Thomas Lenarz, Daniel Schurzig","doi":"10.1097/MAO.0000000000004520","DOIUrl":"10.1097/MAO.0000000000004520","url":null,"abstract":"<p><strong>Hypothesis: </strong>Machine learning models can assist with the selection of electrode arrays required for optimal insertion angles.</p><p><strong>Background: </strong>Cochlea implantation is a successful therapy in patients with severe to profound hearing loss. The effectiveness of a cochlea implant depends on precise insertion and positioning of electrode array within the cochlea, which is known for its variability in shape and size. Preoperative imaging like CT or MRI plays a significant role in evaluating cochlear anatomy and planning the surgical approach to optimize outcomes.</p><p><strong>Methods: </strong>In this study, preoperative and postoperative CT and CBCT data of 558 cochlea-implant patients were analyzed in terms of the influence of anatomical factors and insertion depth onto the resulting insertion angle.</p><p><strong>Conclusions: </strong>Machine learning models can predict insertion depths needed for optimal insertion angles, with performance improving by including cochlear dimensions in the models. A simple linear regression using just the insertion depth explained 88% of variability, whereas adding cochlear length or diameter and width further improved predictions up to 94%.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e234-e242"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151380","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":"Intelligence Quotient Testing in Children With Cochlear Implantation: A Systematic Review and Meta-Analysis.","authors":"Liliya Benchetrit, Shannon Wu, Diya Ramanathan, Mihika Thapliyal, Suzanne Sutliff, David H Chi, Ksenia Aaron, Jessica R Levi, Patricia Klaas, Samantha Anne","doi":"10.1097/MAO.0000000000004538","DOIUrl":"10.1097/MAO.0000000000004538","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate intelligence quotient (IQ) scores among children with bilateral hearing loss (HL) pre- and post-cochlear implantation (CI) and compared with normative means.</p><p><strong>Databases reviewed: </strong>PubMed (MEDLINE), Embase, Cochrane, and CINAHL databases searched until December 2021.</p><p><strong>Methods: </strong>Studies of patients 1) 18 years or younger (2) with bilateral sensorineural HL diagnosis who underwent CI, and (3) with ≥1 specific IQ score post-CI were included. Mean differences in IQ scores pre- and post-CI and compared with normal-hearing controls were meta-analyzed. Studies not amenable to meta-analysis were qualitatively analyzed.</p><p><strong>Results: </strong>Included 15 articles (636 patients, 247 age-matched normal-hearing controls), with mean (SD) age in years at CI (4.1 [1.5]) and neurocognitive testing (8.6 [1.6]). Children with HL had significant performance IQ score improvement post-CI (MD, 7.0; 95% confidence interval, 1.95 to 12.05; I2 = 0%), and full-scale IQ scores comparable to normal-hearing group (MD 1.52; 95% confidence interval -4.46 to 7.50; I2 = 0%). Qualitatively, 9 of 12 studies evaluating performance IQ and 5 of 6 studies evaluating full-scale IQ showed mean scores of children with CI comparable to normative means, whereas 5 of 6 studies reported verbal IQ scores lower than normative means.</p><p><strong>Conclusions: </strong>Children with CI show significant improvement in full-scale and performance IQ testing, with a significant proportion achieving normal ranges scores. Verbal IQ scores remain lower than normative means, even after CI, likely due to the reduced access to sound before CI. Earlier implantation and therefore earlier access to sound may help lessen the impact on verbal IQ in these children.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e257-e268"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226143","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":"Effects of CI Electrode Pullback on Electrophysiology, Audiology, and Postoperative Imaging.","authors":"Gina Mittmann, Philipp Mittmann, Jelena Bevanda, Anne-Marie Demel, Arneborg Ernst, Lenneke Kiefer, Rainer Seidl, Sven Mutze, Leonie Goelz","doi":"10.1097/MAO.0000000000004519","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004519","url":null,"abstract":"<p><strong>Introduction: </strong>The position between the cochlea implant (CI) electrode array and the neural structures is crucial for the audiological outcome in CI surgery. Using the pullback technique, an electrode position closer to the modiolus can be achieved in perimodiolar electrode arrays. An approximation to the modiolus could be demonstrated by improved electrophysiological recordings after finalizing the pullback.</p><p><strong>Methods: </strong>Forty-six patients were implanted with Nucleus Slim perimodiolar electrode arrays (Cochlear Pty, Sydney). After complete insertion of the electrode, a controlled pullback by about 1.5 mm was performed in 20 subjects. Electrophysiological measurements were performed before and after the pullback. Radiological examination was performed on the first day postoperative with flat-panel tomography.</p><p><strong>Results: </strong>Significant lower threshold neural response telemetry data were found between electrodes 7 and 11 after the pullback. Impedances remained unchanged during this procedure. Radiological and audiological examination revealed nonsignificant changes between both groups.</p><p><strong>Discussion: </strong>In this series, a pullback of the CI electrode after full insertion showed an improved electrophysiological pattern of neural response telemetry data intraoperatively. It remains a matter for further studies to correlate those data with long-term audiological outcome data.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675428","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, Timbre, and Pitch Perception in Cochlear Implant Users With Flat-Panel CT-Based Frequency Reallocations: A Longitudinal Prospective Study.","authors":"Melanie L Gilbert, Rebecca M Lewis, Mickael L D Deroche, Nicole T Jiam, Patpong Jiradejvong, Jonathan Mo, Daniel L Cooke, Charles J Limb","doi":"10.1097/MAO.0000000000004595","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004595","url":null,"abstract":"<p><strong>Hypothesis: </strong>To determine whether chronic use of experimental computed tomography (CT)-based frequency allocations would improve cochlear implant (CI) user performance in the areas of speech and music perception, as compared to the clinical default frequency mapping provided by the CI manufacturer.</p><p><strong>Background: </strong>CIs utilize default frequency maps to distribute the frequency range important for speech perception across their electrode array. Clinical default frequency maps do not address the significant frequency-place mismatch that is inherent after cochlear implantation, nor the variability between individual anatomy or array lengths. Recent research has utilized postoperative high-resolution flat-panel CT imaging to measure the precise location of electrode contacts within an individual's cochlea, in order to generate a custom frequency map and decrease the frequency-place mismatch.</p><p><strong>Methods: </strong>A cohort of 10 experienced CI users (14 CI ears) was recruited to receive CT scans and then use an experimental CT-based frequency map for 1 month. The efficacy of these maps was measured using a battery of speech and music tests.</p><p><strong>Results: </strong>No change in speech or music performance between the Experimental and Clinical Maps was found at the group level, although there was large variability within the cohort. Greater benefit from the Experimental Map on speech in quiet tasks was correlated with better electrode array alignment in the apical (low frequency) region (rho14 = -0.55 to -0.72, p < 0.05).</p><p><strong>Conclusion: </strong>This application of strict CT-based mapping was most beneficial for CI users with the least amount of apical-mid array frequency-place mismatch, and least beneficial for CI users with overly deep or shallow insertions. Results may be limited by long acclimation periods to clinical default frequency maps prior to CT map usage, intervention bias, and small sample size.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675436","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}