Vormelcher Sarah, Batsoulis Cornelia, Kley Daniel, Mair Michael, Büchner Andreas
Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany.
MED-EL Research Center, MED-EL Medical Electronics GmbH, Hannover, Germany.
Front Neurol. 2025 Jul 4;16:1618031. doi: 10.3389/fneur.2025.1618031. eCollection 2025.
Impedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments, offering limited temporal resolution of impedance changes. This study aimed to address this gap by implementing daily impedance monitoring using a smartphone app.
A prospective study evaluated the usability of a research app for remote impedance measurements over 4 months following standard CI surgery with a MED-EL FLEX28 electrode. Impedance was recorded twice daily (morning and evening). The mean impedance across all electrode channels was analyzed for four postoperative time periods: early postoperative (up to day 10 postoperatively), late postoperative (from day 11 to ~4 weeks), intensive fitting (from ~4 weeks postoperatively to ~7 weeks) and regular hearing phase (from ~7 weeks to 4 months). Two CI fitting approaches were compared: activation during the early postoperative phase (early activation, EA) and activation during the intensive fitting phase (conventional activation, CA). Morning-to-evening differences in impedance (MED) were also examined.
The app demonstrated an overall usage rate of 66% ( = 28), indicating moderate-to-high adherence. Except for higher evening impedance values with CA in the late postoperative phase, no significant differences in mean impedance between the fitting approaches were observed (EA: 6.46 kΩ, = 11; CA: 7.82 kΩ, = 11; = 0.04). Significant differences in MED were found during the early postoperative phase (EA: 0.06 kΩ, = 8; CA: -0.18 kΩ, = 10; = 0.04) and the late postoperative phases (EA: 0.85 kΩ, = 11; CA: 0.03 kΩ, = 11; < 0.001).
Remote impedance measurements via the app can be made over an extended postoperative period. The increased measurement frequency allowed for detailed characterization of impedance dynamics, particularly around the onset of electrical stimulation. No clinically relevant difference in mean impedance was found between EA and CA groups. Daily fluctuations showed consistently lower evening values after stimulation onset. These findings highlight the potential value of this approach for enhancing postoperative CI management.
人工耳蜗（CI）植入者的阻抗遥测测量通常用于评估CI电极功能，并为内耳状况提供有价值的见解。然而，这些测量通常仅在手术期间和临床随访预约时进行，提供的阻抗变化时间分辨率有限。本研究旨在通过使用智能手机应用程序进行每日阻抗监测来填补这一空白。
一项前瞻性研究评估了一款研究应用程序在使用MED-EL FLEX28电极进行标准CI手术后4个月内进行远程阻抗测量的可用性。每天记录两次阻抗（早上和晚上）。分析了四个术后时间段内所有电极通道的平均阻抗：术后早期（术后10天内）、术后晚期（第11天至约4周）、强化调试期（术后约4周至约7周）和常规听力阶段（约7周至4个月）。比较了两种CI调试方法：术后早期激活（早期激活，EA）和强化调试期激活（传统激活，CA）。还检查了早上到晚上的阻抗差异（MED）。
该应用程序的总体使用率为66%（n = 28），表明依从性为中到高。除了术后晚期CA组的晚上阻抗值较高外，未观察到调试方法之间的平均阻抗有显著差异（EA：6.46 kΩ，n = 11；CA：7.82 kΩ，n = 11；P = 0.04）。在术后早期（EA：0.06 kΩ，n = 8；CA：-0.18 kΩ，n = 10；P = 0.04）和术后晚期（EA：0.85 kΩ，n = 11；CA：0.03 kΩ，n = 11；P < 0.001）发现MED有显著差异。
通过该应用程序进行的远程阻抗测量可以在术后较长时间内进行。测量频率的增加使得能够详细表征阻抗动态，特别是在电刺激开始时。EA组和CA组之间在平均阻抗上未发现临床相关差异。刺激开始后，每日波动显示晚上的值始终较低。这些发现突出了这种方法在加强术后CI管理方面的潜在价值。
