Introduction

The goal of this prospective study is to safeguard remaining hearing capabilities and enhance speech outcomes through the personalized positioning of a cochlear implant (CI) electrode array. Preoperative computer tomography (CT) imaging and intraoperative ECochG monitoring determine this positioning. The study focuses on cochlear implant candidates who have pronounced hearing in the low frequency range. These individuals are implanted with a "SlimJ"-Electrode (Advanced Bionics), which is only partially inserted. This approach aims to mitigate insertion-related trauma and maintain the integrity of residual low-frequency hearing.

Methods

Preceding the surgical procedure, participant CT scans are examined using the CImago software (Advanced Bionics). A report is generated with the following analysis data: 1) 3D cochlear model, 2) cochlear height measurements, 3) estimated rotation depths for a different number of electrode contacts, 4) estimated Greenwood frequency (Greenwood 1961) appearing at the tip of the array for each of the theoretically inserted contact numbers. Utilizing this dataset, a target insertion depth is determined for each participant prior to the surgical procedure.

Results

The preliminary results show that the placement of the electrodes at the previously defined locations is feasible. Subsequent measurements of speech intelligibility and the hearing thresholds, reveal a consistent improvement during the initial six months following surgery.

Conclusion

The initial data highlights the significance of individualized cochlear implantation, which includes the determination of the individual insertion depth by CT data and intraoperative ECochG monitoring. This approach helps to ensure that structural aspects and residual hearing are preserved.

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