Hearing preservation (HP) and protection of cochlear structures are essential for optimal patient outcomes post cochlear implantation. Contrary to earlier assumptions around hearing preservation with the Contour Advance, surgeons have observed comparable hearing preservation outcomes for the slim modiolar electrode (SME) and the slim straight electrode (SSE). In this Science Spotlight, we examine the findings of Geng et al.’s systematic review and meta-analysis comparing HP rates between these two electrode types.
Key Findings:
- The SME and SSE exhibit similar hearing preservation capabilities between 0-12 months
- Beyond 12 months, the SME maintains a stable HP rate, whereas the SSE shows a prominent decline
- Lateral wall electrodes are more likely to cause trauma to the basilar membrane (BM), possibly due to the electrodes contact with delicate structures, and the body’s fibrotic response to a foreign object. This pressure on the BM is a likely contributor to delayed hearing loss and reduced long term HP.
Historically, straight electrodes were believed to offer superior HP based on earlier studies involving traditional straight and stylet based perimodiolar designs. However, the introduction of the sheath-based SME has shifted this perspective. The findings presented by Geng et al. challenge outdated assumptions and suggest a reevaluation of preferred electrode designs.
In their analysis, Geng et al. highlight changes in HP rates over time. The SME demonstrated an initial HP rate of 59.07%, which remained nearly unchanged at 59.09% in long-term follow-up. In contrast, the SSE showed a decline from 68% initially to 56.38%. This suggests that the SME offers greater long-term consistency, making it an excellent choice for preservation of structures and an atraumatic design.
This data aligns with the thin, atraumatic design goals of the SME. By positioning itself closer to the modiolus and away from the lateral wall, the SME avoids direct trauma to the BM and allows space for fibrotic tissue to develop without exerting damaging pressure. This growing body of evidence creates a compelling case for surgeons considering the SME. These advantages make it a preferable option for patients where hearing outcomes and structural preservation is a priority.
For more information about hearing preservation and varying electrodes, please contact your local Cochlear representative or read the article here.
This blog is intended to serve as a resource for clinicians to help keep up to date with current clinical literature and is intended for professionals only. Clinical literature is based on research, which may include the experimental use of new or currently available products and technologies. Therefore, literature presented on this blog may represent use of Cochlear products that does not align with the intended use or indications approved by regulatory bodies, also known as off-label use. Cochlear does not condone any off-label use of its products, and it is not Cochlear’s intent to promote off-label use by providing this blog as a resource for healthcare professionals.
