Proper placement of an electrode array is essential for maximizing postoperative performance outcomes with a cochlear implant. Imaging is typically the standard of care for confirming proper electrode placement; however, electrophysiologic techniques (such as Placement Check in the Cochlear™ Nucleus® SmartNav System) are now being utilized to assess electrode placement. Because instances of electrode complication are exceedingly rare, this multi-center study by Arambula, et al. (2025)1 pooled data from three institutions to obtain a larger subject pool to assess the effectiveness of Placement Check compared to imaging.
Key Highlights:
- N of 484, Placement Check results compared to intraoperative imaging
- Sensitivity and Specificity: Transimpedance Matrix Measurement (TIM) recordings showed 100% sensitivity, 99.6% specificity
- TIM recordings are highly effective in identifying electrode complications, showing comparable or superior performance to intraoperative imaging.
- TIM can potentially reduce the need for routine intraoperative x-rays, minimizing surgical time, cost, and radiation exposure without compromising patient care.
- Only 2.7% rate of electrode complications (13 of 484)
This study reveals that not only are electrophysiologic measurements valid at identifying electrode complication, but they may also be superior to the current gold standard of X-Ray, which can be open to misinterpretation. For more information, read the full article here.
1 Arambula AM, Piper R, Murray G, Mowry SE, Rivas A, Semaan M, Manzoor NF, Killeen DE, Kelsall DC, Lupo JE, Biever A, Stidham KR, Albinus R, Morgan S, Kaplan BJ, Presley R, Menendez S, Tejani VD. Sensitivity and Specificity of Intraoperative TransImpedance Matrix Recordings Compared With X-ray Imaging in Detecting Perimodiolar Cochlear Implant Tip Foldovers: A Multicenter Study. Otol Neurotol. 2025 Apr 3. doi: 10.1097/MAO.0000000000004502. Epub ahead of print. PMID: 40210225.
