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Effect of Electrode Posi/on on Electrophysiological and Psychophysical Parameters in CI Pa/ents with Lateral and Perimodiolar Electrode Arrays Chantal Degen, MD presented at: CI 2017 Hannover Medical School Department of Otorhinolaryngology Chairman: Thomas Lenarz MD, Ph.D.

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EffectofElectrodePosi/ononElectrophysiologicalandPsychophysicalParametersinCIPa/entswith

LateralandPerimodiolarElectrodeArrays

ChantalDegen,MDpresentedat:CI2017

HannoverMedicalSchoolDepartmentofOtorhinolaryngology

Chairman:ThomasLenarzMD,Ph.D.

Disclosures

•  FinancialSupportfromCochlearDeutschlandGmbH&Co.KG:– ConferenceFeeandTravelCosts

HighResolu/onCBCTImaging(Morita)

Slicethickness=125µm

Whythemedialwall?

MicroCTfromAvcietal.(2014)J.Comp.Neurol.

Cochlear Nucleus 522 „SRA“

Lateral artifacts

Cochlear Nucleus 532 „MRA“

Medial artifacts

Lateralwallvs.PerimodiolarArrays

CochleaMeasurementTool

CometProgram:Lexowetal.,2016.VisualizaTon,measurementandmodellingofthecochleausingrotaTngmidmodiolarsliceplanes.IntJComputAssistRadiolSurg.11(10):1855-69.doi:10.1007/s11548-016-1374-7.

Using3DReconstruc/ontoDeterminetheEMD

Electrodes

Perimodiolar Lateral wall

“MRA” 532

“Contour” 512 522

522

Preformed electrode array Straight electrode array

“SRA”

ElectrodePosi/on:Perimodiolarvs.LateralArraysNucleus 522

Nucleus 532

0.0

0.4

0.8

1.2

1.6

2.0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

EMD [mm]

Electrode No.

Electrode Modiolus Distance in Perimodiolar vs. Lateral Arrays

532 522 512

0.0

0.4

0.8

1.2

1.6

2.0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

EMD [mm]

Electrode No.

Electrode Modiolus Distance in Perimodiolar vs. Lateral Arrays

532 522 512

0.0

0.4

0.8

1.2

1.6

2.0

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

EMD [mm]

Electrode No.

Electrode Modiolus Distance in Perimodiolar vs. Lateral Arrays

532 522 512

0.0

0.4

0.8

1.2

1.6

2.0

1 3 5 7 9 11 13 15 17 19 21

Electrode- Modiolus Distance

[mm]

Electrode number (basal to apical)

Nucleus 512

n= 10 per Group; Error bars: ± 1SD

Example:SpreadofExcita/onMeasurementCurveforElectrode15

0

20

40

60

80

100

120

140

160

180

200

10 11 12 13 14 15 16 18 19 20 21 22

ECAPAmplitudeatCurrentLevel200[µV]

MaskerElektrode

SOEWidthat½Amplitude

RecordingElectrodeProbeAcTveElectrode

Posi/veCorrela/onbetweenEMDandSpreadofExcita/onWidth

(Averages) Nucleus 532 (MRA: n=11) Nucleus 522 (SRA: n=10)

R²=0.41979

0.5

1.5

2.5

3.5

4.5

0.5 1 1.5

SOEWidth[mm]

Electrode-Modiolus-Distance[mm]

•  TheSOEbecomeswiderwithincreasingdistancetothemodiolus.

R²=0.89128

1

2

3

4

0.5 1 1.5

SOEWidth[mm]

Electrode-Modiolus-Distance[mm]

R²=0.1311

3

3.5

4

4.5

5

5.5

6

0.5 0.6 0.7 0.8 0.9 1

T-Level[nC]

Electrode-Modiolus-Distance[mm]

Nucleus 532 (MRA) Nucleus 522 (SRA)

Posi/veCorrela/onbetweenEMDandT-Levels(Averages)

•  PsychophysicalvaluesforMRA<PsychophysicalvaluesforSRA

R²=0.0383

3

3.5

4

4.5

5

5.5

6

0 0.5 1 1.5 2

T-Level[nC]

Electrode-Modiolus-Distance[mm]

Nucleus 532 (MRA)

Nucleus 522 (SRA)

Posi/veCorrela/onbetweenEMDandC-Levels(Averages)

R²=0.17254

8

8.5

9

9.5

10

10.5

11

11.5

12

12.5

13

0.5 0.8 1.1 1.4 1.7 2

C-Level[nC]

Electrode-Modiolus-Distance[mm]

•  PsychophysicalvaluesforMRA<PsychophysicalvaluesforSRA

R²=0.33071

8

8.5

9

9.5

10

10.5

11

11.5

12

12.5

13

0.5 0.6 0.7 0.8 0.9 1

C-Level[nC]

Electrode-Modiolus-Distance[mm]

0.00

4.00

8.00

12.00

16.00

1 3 5 7 9 11 13 15 17 19 21

T-/C-Level (Q) [nC]

Electrode No.

Psychophysical Thresholds

522 C-Level 512 C-Level 532 C-Level 522 T-Level 512 T-Level 532 T-Level

R²=0.1365

6

8

10

12

14

16

18

0.5 0.7 0.9 1.1

t-NRT[nC]

AverageEMD

•  TheECAPthresholdsbecomehigherwithincreasingdistancetothemodiolus.

Posi/veCorrela/onbetweenEMDandECAPThresholds(Averages)

Nucleus 532 (MRA) Nucleus 522 (SRA)

R²=0.07094

6

8

10

12

14

16

0.2 1 1.8

t-NRT[nC]

AverageEMD

SpeechPercep/onatthe1stFi]ng

0

10

20

30

40

50

60

70

80

90

100

Numbers Monosyllables HSM HSM+10dBnoise

[%]MRA(n=10)

Contour(n=10)

SRA(n=10)

No significant differences in speech perception in each test*.

*ANOVA

•  NewCBCTresoluTonallowsformeasurementofsingleelectrodeEMDinpostoperaTveCBCTscans

•  SOEWidthincreaseswithlargerdistancetothemodiolus

•  T-Levels,C-LevelsandECAPthresholdsarelowerinperimodiolararrays

Summary

Thankyouforyoura_en/on.