Computed-Tomography Estimates of Interaural Mismatch in Insertion Depth and Scalar Location in Bilateral Cochlear-Implant Users.

Autor:	Goupell MJ; Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland., Noble JH, Phatak SA; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland., Kolberg E; Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland., Cleary M; Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland., Stakhovskaya OA, Jensen KK; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland., Hoa M; Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia., Kim HJ; Department of Otolaryngology-Head and Neck Surgery, Georgetown University Medical Center, Washington, District of Columbia., Bernstein JGW; National Military Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2022 Jul 01; Vol. 43 (6), pp. 666-675.
DOI:	10.1097/MAO.0000000000003538
Abstrakt:	Hypothesis: Bilateral cochlear-implant (BI-CI) users will have a range of interaural insertion-depth mismatch because of different array placement or characteristics. Mismatch will be larger for electrodes located near the apex or outside scala tympani, or for arrays that are a mix of precurved and straight types. Background: Brainstem superior olivary-complex neurons are exquisitely sensitive to interaural-difference cues for sound localization. Because these neurons rely on interaurally place-of-stimulation-matched inputs, interaural insertion-depth or scalar-location differences for BI-CI users could cause interaural place-of-stimulation mismatch that impairs binaural abilities. Methods: Insertion depths and scalar locations were calculated from temporal-bone computed-tomography scans for 107 BI-CI users (27 Advanced Bionics, 62 Cochlear, 18 MED-EL). Results: Median interaural insertion-depth mismatch was 23.4 degrees or 1.3 mm. Mismatch in the estimated clinically relevant range expected to impair binaural processing (>75 degrees or 3 mm) occurred for 13 to 19% of electrode pairs overall, and for at least three electrode pairs for 23 to 37% of subjects. There was a significant three-way interaction between insertion depth, scalar location, and array type. Interaural insertion-depth mismatch was largest for apical electrodes, for electrode pairs in two different scala, and for arrays that were both-precurved. Conclusion: Average BI-CI interaural insertion-depth mismatch was small; however, large interaural insertion-depth mismatch-with the potential to degrade spatial hearing-occurred frequently enough to warrant attention. For new BICI users, improved surgical techniques to avoid interaural insertion-depth and scalar mismatch are recommended. For existing BI-CI users with interaural insertion-depth mismatch, interaural alignment of clinical frequency tables might reduce negative spatial-hearing consequences. Competing Interests: The authors disclose no conflicts of interest. (Copyright © 2022, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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