Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Otol Neurotol. 2022 Aug 1;43(7):e726-e729. doi: 10.1097/MAO.0000000000003570. Epub 2022 Jul 4.
Review the effectiveness of an alternative mapping procedure of a precurved electrode array in the internal auditory canal (IAC).
A 7-year-old bilateral cochlear implant (CI) recipient of precurved arrays transferred to the study site and demonstrated no speech recognition with the left CI. Imaging revealed bilateral incomplete partition type III malformations. For the left CI, four contacts were observed in the basal cochlear turn and 18 contacts were coiled in the IAC. The family decided against revision surgery. Pitch ranking was completed to map the contacts in the IAC that were perceptually discrete and tonotopically organized.
For the left CI, PB-K word recognition improved from no recognition to 32% after 1 month and to 52% after 3 months. In the bilateral CI condition, performance improved from 56 to 72% after 1 month and 80% after 3 months.
A precurved array in the IAC creates difficult management decisions. Direct stimulation of the auditory nerve resulted in better monaural and bilateral speech recognition, likely due to better spectral representation of the speech signal. Individualizing the map using imaging and behavioral findings may improve performance for malpositioned arrays when revision surgery is not pursued.
回顾在内部听觉道（IAC）中使用预弯曲电极阵列的替代映射程序的效果。
一名 7 岁双侧人工耳蜗植入（CI）受者，使用预弯曲阵列转至研究地点，发现左侧 CI 无法识别语音。影像学显示双侧不完全分隔 III 型畸形。对于左侧 CI，在基底耳蜗转角观察到四个触点，18 个触点在 IAC 中缠绕。家庭决定不进行修正手术。音高排序用于映射 IAC 中感知离散且音位组织的触点。
对于左侧 CI，PB-K 单词识别在 1 个月后从无法识别提高到 32%，在 3 个月后提高到 52%。在双侧 CI 条件下，性能在 1 个月后从 56%提高到 72%，在 3 个月后提高到 80%。
IAC 中的预弯曲阵列会产生困难的管理决策。直接刺激听神经导致更好的单耳和双耳语音识别，可能是由于语音信号的频谱表示更好。当不进行修正手术时，使用影像学和行为学发现对定位不当的阵列进行个体化映射可能会提高性能。
