AOS022 - Speech Recognition Performance Differences Between Precurved and Straight Electrode Arrays
Saturday, April 30, 2022
7:56 AM – 8:03 AM CT
Location: Landmark A
Rahul K. Sharma, MD
Miriam R. Smetak, MD
Ankita Patro, MD
Nathan R. Lindquist, MD
Elizabeth L. Perkins, MD
Jourdan T. Holder, AuD, PhD
Kareem Tawfik, MD
Resident Physician Vanderbilt University Medical Center Vanderbilt University Medical Center
Objective: Precurved cochlear implant (CI) electrode arrays have shown superior audiometric outcomes compared to straight electrodes. Previously reported results are confounded by other influential variables such as pre-operative hearing and age. This study compares hearing outcomes for precurved and straight electrodes while controlling for other factors.
Study Design: Retrospective Cohort Study
Setting: Tertiary Academic Medical Center
Patients: 171 adult CI recipients between 2015-2020 with Cochlear brand 522/622 (straight) or 532/632 (precurved) electrode arrays.
Interventions: None
Main Outcome Measures: Speech recognition testing (CNC and AzBio) was collected at 6 and 12 months post-activation. Analyses included Fisher’s exact test, chi-square test of independence, and multivariable linear regression models.
Results: 171 patients (189 ears) with either 6-month and/or 12-month CNC or AzBio testing were included. 112 (59%) and 77 (41%) ears were implanted with straight and precurved electrode arrays respectively. Average age at implantation was 69 years (IQR 58-77). CNC scores were significantly different (p=0.008) between straight (52% Correct, IQR 36-68) andprecurved arrays (66% Correct, IQR 48-74). AzBio scores were not significantly different (p=0.130) between straight (74% Corrected, IQR 56-86) and precurved arrays (82% correct, IQR 58-90). Controlling for age, race, sex, pre-operative hearing, and follow-up time, precurved electrodes performed significantly better on CNC (b=9.42, 95% CI 2.75-16.1, p=0.006) but not AzBio (b=6.48, 95% CI -1.21-14.2, p=0.10) testing.
Conclusions: Precurved electrodes exhibit superior speech recognition scores at 6 and 12 months postoperatively. Strong consideration should be given to implanting precurved electrode arrays due to benefits associated with perimodiolar positioning.
*Professional Practice Gap & Educational Need: Understanding the difference in audiometric outcomes between precurved and straight electrodes will help to guide electrode selection.
*Learning Objective: To understand differences in speech recognition scores post-operatively by electrode type (precurved vs. straight)
*Desired Result: To demonstrate a difference in hearing performance post-operatively by electrode type.
*Level of Evidence: III
*Indicate IRB or IACUC: Approved by the Vanderbilt University IRB (# 090155)