DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20213279

Comparison of residual hearing preservation and auditory based performance after paediatric cochlear implantation by round window insertion versus cochleostomy technique: an ambispective cohort study

Dayana Antony, Aneena Chacko, Arodiyil Ravi

Abstract


Background: Cochlear implantation (CI) has revolutionized the treatment of sensorineural deafness. The aim of the study was to compare auditory based performance in cochlear implants who underwent round window insertion and cochleostomy.

Methods: Ambispective cohort study was done among the children who underwent perilingual cochlear implant in a tertiary care hospital for period of 1 year. Children who satisfied the inclusion criteria were selected and randomly subdivided into 2 groups: group A- round window insertion and group B-cochleostomy. Pre- and post-operative pure tone average (PTA) and residual hearing preserved were evaluated among the cochleostomy and round window insertion groups separately. Post-operatively, children were evaluated, from three months to 1 year from the activation of cochlear implant, with the use of scores such as Category of Auditory Performance (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility rating (SIR) and Meaningful use of speech scale (MUSS score) to measure speech production skills by auditory verbal therapist.   

Results: A total of 80 patients were included in the study. Complete hearing preservation (within 10 dB) was significantly high in round window insertion group compared to   cochleostomy technique (p<0.001). None the subjects had complete loss of residual hearing. On evaluating the post CI performance, MAIS score in the round window insertion group (9.34, 18.21, 27.79) were significantly better compared to cochleostomy group during the 3 months, 6 months and 12 months follow-up.

Conclusions: Round window insertion technique is significantly more successful in complete hearing preservation at low frequencies compared to cochleostomy technique. Among the auditory scores, only MAIS in the round window insertion group was found to be significantly better compared to cochleostomy group.


Keywords


Cochleostomy, Round window insertion, Sensorineural deafness

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References


Cohen NL. Cochlear implant candidacy and surgical considerations. Audiol Neurootol. 2004;9(4):197-202.

Copeland BJ, Pillsbury HC. Cochlear implantation for the treatment of deafness. Annu Rev Med. 2004;55:157-67.

Dowell RC, Hollow R, Winton E. Outcomes for cochlear implant users with significant residual hearing: implications for selection criteria in children. Arch Otolaryngol Head Neck Surg. 2004;130(5):575-81.

Lehnhardt E. Intracochlear placement of cochlear implant electrodes in soft surgery technique. HNO. 1993;41(7):356-9.

Gualya AJ, Minor LB, Poe DS. Glasscock-Shambaugh Surgery of the Ear. 6th ed. New York, NY: McGraw Hill; 2010: 51-52.

Mansour S, Magnan J, Haidar H, Nicolas K, Louryan S. Comprehensive and Clinical Anatomy of the Middle Ear. New York, NY: Springer; 2019.

Brackmann DE, Nissen RL. Menière's disease: results of treatment with the endolymphatic subarachnoid shunt compared with the endolymphatic mastoid shunt. Am J Otol. 1987;8(4):275-82.

Archbold S, Lutman ME, Marshall DH. Categories of Auditory Performance. Ann Otol Rhinol Laryngol Suppl. 1995;166:312-4.

Allen C, Nikolopoulos TP, Dyar D, Donoghue GM. Reliability of a rating scale for measuring speech intelligibility after pediatric cochlear implantation. Otol Neurotol. 2001;22(5):631-3.

Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino FG. Cochlear implantation at under 12 months: report on 10 patients. Laryngoscope. 2005;115(3):445-9.

Neill C, Donoghue GM, Archbold SM, Nikolopoulos TP, Sach T. Variations in gains in auditory performance from pediatric cochlear implantation. Otol Neurotol. 2002;23(1):44-8.

Allen MC, Nikolopoulos TP, Donoghue GM. Speech intelligibility in children after cochlear implantation. Am J Otol. 1998;19(6):742-6.

Robbins AM, Renshaw JJ, Berry SW. Evaluating meaningful auditory integration in profoundly hearing-impaired children. Am J Otol. 1991;12:144-50.

Pinto ES, Lacerda CB, Porto PR. Comparison between the IT-MAIS and MUSS questionnaires with video-recording for evaluation of children who may receive a cochlear implantation. Braz J Otorhinolaryngol. 2008;74(1):91-8.

Friedland DR, Samuelson C. Soft cochlear implantation: rationale for the surgical approach. Trends Amplif. 2009;13(2):124-38.

Skarzynski H, Lorens A, Piotrowska A, Anderson I. Preservation of low frequency hearing in partial deafness cochlear implantation (PDCI) using the round window surgical approach. Acta Otolaryngol. 2007;127(1):41-8.

Skarzyński H, Lorens A, Haese P, Walkowiak A, Piotrowska A, Sliwa L, et al. Preservation of residual hearing in children and post-lingually deafened adults after cochlear implantation: an initial study. ORL J Otorhinolaryngol Relat Spec. 2002;64(4):247-53.

Briggs RJ, Tykocinski M, Stidham K, Roberson JB. Cochleostomy site: implications for electrode placement and hearing preservation. Acta Otolaryngol. 2005;125(8):870-6.

Kang BJ, Kim AH. Comparison of cochlear implant performance after round window electrode insertion compared with traditional cochleostomy. Otolaryngol Head Neck Surg. 2013;148(5):822-6.

Elafandi H, Khalifa MA, Elguindy AS. Cochlear implantation outcomes with round window electrode insertion versus cochleostomy insertion. Int J Pediatr Otorhinolaryngol. 2020;138:110272.

Zanetti D, Nassif N, Zinis LO. Factors affecting residual hearing preservation in cochlear implantation. Acta Otorhinolaryngol Ital. 2015;35(6):433-41.

Causon A, Verschuur C, Newman TA. A Retrospective Analysis of the Contribution of Reported Factors in Cochlear Implantation on Hearing Preservation Outcomes. Otol Neurotol. 2015;36(7):1137-45.

Adunka OF, Buss E, Clark MS, Pillsbury HC, Buchman CA. Effect of preoperative residual hearing on speech perception after cochlear implantation. Laryngoscope. 2008;118(11):2044-9.

Briggs RJ, Tykocinski M, Xu J, Risi F, Svehla M, Cowan R, et al. Comparison of round window and cochleostomy approaches with a prototype hearing preservation electrode. Audiol Neurootol. 2006;11(1):42-8.

Lenarz T, Stover T, Buechner A, Paasche G, Briggs R, Risi F, et al. Temporal bone results and hearing preservation with a new straight electrode. Audiol Neurootol. 2006;11(1):34-41.

Hao QQ, Yan Y, Ren W, Xu GY, Liu RY, Li JN, et al. One-stage coclear implantation via a facial recess approach in children with otitis media with effusion. J Otol. 2015;10(3):125-9.

Gudis DA, Montes M, Bigelow DC, Ruckenstein MJ. The round window: is it the "cochleostomy" of choice? Experience in 130 consecutive cochlear implants. Otol Neurotol. 2012;33(9):1497-501.