Comparison of Perimodiolar Electrodes: Imaging and Electrophysiological Outcomes.

Abstract

The perimodiolar CI532 Slim Modiolar electrode has been designed to bring the electrode contacts close to auditory nerve while reducing cochlear trauma during its insertion. It is currently unknown to what extent the electrode position and electrophysiological outcomes of the Slim Modiolar electrode differ from other perimodiolar electrodes. The objective was to compare the electrode position and electrophysiological outcomes between the CI532 Slim Modiolar and CI512 Contour Advance electrode. Forty-six adult patients received a Slim Modiolar or Contour Advance electrode. Electrode types were compared using intraoperative electrode impedances, evoked compound action potential (ECAP) and stapedius reflex thresholds, as well as position parameters from postoperative computed tomography or digital volume tomography images (medial-lateral position, electrode-to-modiolus distance, insertion angle). The medial-lateral position indicates a closer modiolar placement of the Slim Modiolar compared with the Contour Advance. Individual electrode contact measurements, however, showed significantly larger electrode-to-modiolus distances and higher ECAP thresholds for the Slim Modiolar in the basal region. On contacts E20-22 the Slim Modiolar is slightly closer to the modiolus compared with the Contour Advance, but this did not result in lower ECAP thresholds. Perimodiolar electrodes can vary in their intracochlear position, leading to divergent electrophysiological outcomes. To detect these differences, investigations must be done for each electrode contact rather than using a global factor for the whole electrode array. While the electrode dislocation rate is lower with the Slim Modiolar than with the Contour Advance, electrode-to-modiolus proximity is smaller and ECAP thresholds are lower with the Contour Advance in the basal cochlear region.