Scalar position in cochlear implant surgery and outcome in residual hearing and the vestibular system

Int J Audiol. 2014 Feb;53(2):121-7. doi: 10.3109/14992027.2013.854413. Epub 2013 Dec 4.

Abstract

Objective: To evaluate the effect of the intracochlear electrode position on the residual hearing and VNG- and cVEMP responses.

Design: Prospective pilot study.

Study sample: Thirteen adult patients who underwent unilateral cochlear implant surgery were examined with high-resolution rotational tomography after cochlear implantation. All subjects were also tested with VNG, and 12 of the subjects were tested with cVEMP and audiometry before and after surgery.

Results: We found that although the electrode was originally planned to be positioned inside the scala tympani, only 8 of 13 had full insertion into the scala tympani. Loss of cVEMP response occurred to the same extent in the group with full scala tympani positioning and the group with scala vestibuli involvement. There was a non-significant difference in the loss of caloric response and residual hearing between the two groups. Interscalar dislocation of the electrode inside the cochlea was observed in two patients. A higher loss of residual hearing could be seen in the group with electrode dislocation between the scalae.

Conclusions: Our findings indicate that intracochlear electrode dislocation is a possible cause to loss of residual hearing during cochlear implantation but cannot be the sole cause of postoperative vestibular loss.

MeSH terms

  • Adult
  • Audiometry
  • Cochlear Implantation / adverse effects
  • Cochlear Implantation / instrumentation
  • Cochlear Implantation / methods*
  • Cochlear Implants
  • Correction of Hearing Impairment / adverse effects
  • Correction of Hearing Impairment / instrumentation
  • Correction of Hearing Impairment / methods*
  • Female
  • Hearing Disorders / diagnosis
  • Hearing Disorders / physiopathology
  • Hearing Disorders / psychology
  • Hearing Disorders / therapy*
  • Hearing*
  • Humans
  • Male
  • Middle Aged
  • Nystagmus, Physiologic
  • Persons With Hearing Impairments / psychology
  • Persons With Hearing Impairments / rehabilitation*
  • Prosthesis Design
  • Scala Tympani / diagnostic imaging
  • Scala Tympani / physiopathology*
  • Scala Vestibuli / diagnostic imaging
  • Scala Vestibuli / physiopathology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vestibular Evoked Myogenic Potentials
  • Vestibule, Labyrinth / diagnostic imaging
  • Vestibule, Labyrinth / physiopathology*
  • Video Recording