Relationship Between Electrocochleography, Angular Insertion Depth, and Cochlear Implant Speech Perception Outcomes.
Michael W Canfarotta, Brendan P O'Connell, Christopher K Giardina and 8 others
PMID 33369942WHAT IT FOUND
Combining intraoperative electrocochleography with insertion depth and array design explained 72% of variance in speech perception scores, compared to 43% for electrocochleography alone.
This helps predict outcomes and clarifies how different electrode arrays affect performance.
Key findings
01A model combining total response, angular insertion depth, and array design accounted for 72% of the variance in CNC word scores, whereas total response alone accounted for 43%.
02The relationship between insertion depth and speech perception depends on the array design, with deeper insertions benefiting straight arrays but shallower insertions benefiting pre-curved arrays.
03Total response measurements generally underestimated performance for pre-curved or deeply inserted straight arrays, and overestimated performance for shallower straight arrays.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size for pre-curved array recipients was small (n=9). Speech perception was assessed only at 6 months, so long-term outcomes are not captured. The study did not account for other surgical variables like scalar location (scala tympani vs. vestibuli) or modiolar proximity, which are known to affect outcomes. The analysis was limited to word recognition in quiet, not noise.
The easy way to misread this
Do not assume that deeper insertion is universally better for speech perception. The benefit of insertion depth is dependent on the specific array design: straight arrays benefit from deeper insertion to reduce frequency mismatch, while pre-curved arrays perform well with shallower insertion due to closer proximity to neural structures.