An instructional course on tinnitus

Computational Audiology in Hearing Aid

Abstract:

Purpose: In revisions and in patients with unusual cochlear duct anatomy, optimal CI electrode insertion is the goal to secure patient performance. Verification of placement should be done at surgery.

Methods: Retrospective review of all CI cases in our center between January 1, 2023 and October 15, 2025. Of 131 cases, 6 were revisions for device malfunction, 3 for delayed infection, 3 for intracochlear schwannoma, 4 for basal turn ossification, and two for unexpected cochlear duct soft tissue obstruction. Depth of insertion, wound complications, facial nerve stimulation, balance issues, and comparison to prior performance was analyzed.

Results: 18 (13.7%) patients met criteria for 22-month study period. 5/6 re-implants for device failure achieved full insertion. 1 was inserted to 16/22 electrodes. Removal of the receiver stimulator while leaving the electrode, 6 weeks of culture specific antibiotics, and re-implantation was successfully achieved in 3/3 cases of delayed implant site infection. 2/3 with intracochlear schwannomas had full insertion. 1 had partial insertion. 3/4 with basal turn ossification had full insertion with a drill-through technique. 1 case had a partial insertion. 2/2 patients with unexpected soft tissue obstruction of the basal turn obtained full insertion, 1 was concurrently treated for a round window gusher. All 21 patients in this cohort are full time CI users with average follow-up of 15 months.

Conclusions: Electrode selection and verification of placement are essential components to optimize patient performance in this challenging population. SmartNav estimates both electrode position without a radiograph and provides starting programming parameters in this population.