Comparative Performance of Lateral Wall and Perimodiolar Cochlear Implant Arrays

Otol Neurotol. 2021 Apr 1;42(4):532-539. doi: 10.1097/MAO.0000000000002997.

Abstract

Objective: The physical shape of cochlear implant (CI) arrays may impact hearing outcomes. The goal of this study was to compare post-operative speech and melody perception between patients with lateral wall (LW) and perimodiolar (PM) electrode arrays across a range of lengths and manufacturers.

Study design: Retrospective chart review.

Setting: Tertiary Care Hospital.

Patients: 119 adult patients with post-lingual hearing loss who underwent cochlear implantation.

Main outcome measures: A total of seven different electrodes were evaluated including 5 different LW electrodes (CI422 [Cochlear American], 1J [Advanced Bionics], Medium [Med El], Standard [Med El], Flex28 [Med El]) and 2 PM electrodes (Contour [Cochlear American], MidScala [Advanced Bionics]). Speech perception outcomes (n = 119 patients) were measured by Consonant-Nucleus-Consonant (CNC) scores collected 3, 6, 12 and 24 months after implantation. Melody perception outcomes (n = 35 CI patients and n = 6 normal hearing patients) were measured by Melodic Contour Identification (MCI).

Results: CNC scores increased over time after implantation across all array designs. PM designs exhibited higher CNC scores compared to LW electrodes, particularly 6-months after implantation. Pre-operative pure tone averages did not correlate with post-operative CNC scores. PM arrays outperformed LW electrodes in terms of MCI scores.

Conclusions: The physical shape of cochlear implant electrode arrays may impact hearing performance. Compared to LW designs, PM arrays appear to offer superior speech perception during the first 6 months after implantation, with performance equalizing between groups by 24 months. Compared to LW designs, PM arrays also appear to afford superior melody perception.

MeSH terms

  • Adult
  • Cochlear Implantation*
  • Cochlear Implants*
  • Humans
  • Retrospective Studies
  • Speech Perception*
  • Treatment Outcome