Current Focusing to Reduce Channel Interaction for Distant Electrodes in Cochlear Implant Programs.
Lindsay DeVries, Julie G Arenberg
PMID 30488764WHAT IT FOUND
Cochlear implant programs that focused only electrodes with suspected channel interaction did not improve speech perception over the monopolar control program.
Focusing the wrong electrodes, those near the modiolus, made hearing worse. Selection matters.
Key findings
01Focused-stimulation programs selected by broad tuning or far electrode-to-modiolus distance performed similarly to the monopolar control program on sentence recognition and medial vowel identification.
02Focusing electrodes close to the modiolus produced significantly poorer speech perception than the Distance and Tuning programs.
03In 7 of 13 subjects, broader tuning was significantly correlated with greater electrode-to-modiolus distance.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 13 cochlear implant listeners, and individual benefit varied widely. The programs were tested only in an acute laboratory setting, not with extended everyday listening. When the subjects who used the HINT sentences were removed, the Tuning program was no longer significantly better than the Inverse-Control program for sentence recognition. Postoperative CT scans are not often available to clinicians, incur high costs, and expose patients to radiation. This makes imaging-based channel selection hard to use in routine care. The small number of subjects in each electrode array type prevented further comparison of array types. The Monopolar-Control program was an all-channel monopolar program intended to resemble everyday stimulation, not necessarily each subject's full everyday program.
Declared interests
The funding section names the University of Washington Speech and Hearing Sciences and the National Institute on Deafness and Other Communication Disorders as funders.
The easy way to misread this
Do not conclude that focused-stimulation programs based on tuning or electrode distance improve speech perception over a monopolar program. The Distance and Tuning programs were not significantly better than the Monopolar-Control program, and the study tested these programs only in an acute setting.