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Detection of Extracochlear Electrodes Using Stimulation-Current- Induced Non-Stimulating Electrode Voltage Recordings With Different Electrode Designs.

Published version
Peer-reviewed

Type

Article

Change log

Authors

de Rijk, Simone R 
Hammond-Kenny, Amy 
Tam, Yu C 
Eitutis, Susan T 
Garcia, Charlotte 

Abstract

HYPOTHESIS: Stimulation-Current-Induced Non-Stimulating Electrode Voltage Recordings (SCINSEVs) can help detect extracochlear electrodes for a variety of Cochlear Implant (CI) devices. BACKGROUND: Extracochlear electrodes (EEs) occur in 9 to 13% of cochlear implantations and commonly go unnoticed without imaging. Electrodes on the electrode array located extracochlearly are associated with non-auditory stimulation and a decrease in speech outcomes. We have previously shown that SCINSEVs, with hardware and software from one manufacturer, could detect EEs. Here, we test the generalizability to other manufacturers. METHODS: Fresh-frozen human cadaveric heads were implanted with Cochlear Ltd. CI522 (CI-A) and MED-EL's FLEX24 (CI-B) electrodes. Contact impedances and SCIN- SEVs were measured, with Cochlear Ltd. research Custom Sound software (Transimpedance Matrix) and MED-EL's clinical MAESTRO (Impedance Field Telemetry), for full insertion and EEs in air, saline and soft tissue. An automated detection tool was optimized and tested for these implants. Intra-operative SCINSEVs with EEs were collected for clinical purposes for six patients. RESULTS: The pattern of SCINSEVs changed in the transition zone from intracochlear to extracochlear electrodes, even with low contact impedances on EEs. Automated detection in the cadaveric specimens, with two or more EEs in saline or soft tissue, showed a mean 91% sensitivity and specificity for CI-A and 100% sensitivity and specificity for CI-B. Quantification of EEs showed significant correlations of r  = 0.69 between estimated and actual EEs for CI-A and r = 0.76 for CI-B. CONCLUSION: The applicability of SCINSEVs to detect extra- cochlear electrodes could be expanded to other cochlear implant companies despite differences in electrode array design and measurement software.

Description

Keywords

Cadaver, Cochlea, Cochlear Implantation, Cochlear Implants, Electric Impedance, Electrodes, Electrodes, Implanted, Humans

Journal Title

Otol Neurotol

Conference Name

Journal ISSN

1531-7129
1537-4505

Volume Title

43

Publisher

Ovid Technologies (Wolters Kluwer Health)
Sponsorship
Medical Research Council (MC_UU_00005/3)
MRC (MC_UU_00030/4)