title: Threshold, comfortable level and impedance changes as a function of electrode-modiolar distance.
abstract: OBJECTIVE
  The study investigated the hypothesis that threshold and comfortable levels recorded from cochlear implant patients would reduce, and dynamic range increase, as distance of the electrode from the modiolar wall (radial distance) decreases. Two groups of cochlear implant patients participated; one group using the Nucleus' 24 Contour electrode array, and one group using the Nucleus standard straight (banded) array. The Nucleus 24 Contour array has been shown in temporal bone studies to lie closer to the modiolus than the banded array. The relationship of electrode impedance and radial distance is also investigated.
  
  
  METHODS
  The study, conducted at three centers, evaluated 21 patients using the Contour array, and 36 patients using the banded array. For each patient, threshold, comfortable levels and dynamic range were measured at four time points. Common ground electrode impedance was recorded clinically from each patient, at time intervals up to 12 wk. An estimate of the radial distance of the electrode from the modiolus was made by analysis of Cochlear view x-rays.
  
  
  RESULTS
  Threshold and comfortable levels were significantly lower for the Nucleus 24 Contour array than for the banded array. However, dynamic range measurements did not show the predicted increase. In a majority of subjects, a significant correlation was found between the estimated radial distance of the electrode from the modiolus and the measured threshold and comfortable levels. This trend was not observed for dynamic range. The analysis indicates that other factors than radial distance are involved in the resultant psychophysical levels. Clinical impedance measures (common ground) were found to be significantly higher for the Contour array. However, the electrodes on the Contour array are half-rings, which are approximately only half the geometric size of the full rings as electrodes of the standard array. When the geometric electrode area in the two array designs are normalized, the trends in the electrode impedance behavior are similar.
  
  
  CONCLUSIONS
  The results support the hypothesis that the relationship between the radial distance of the electrode and the psychophysical measures are influenced by patterns of fibrous tissue growth and individual patient differences, such as etiology and neural survival. Impedance measures for the Nucleus 24 Contour electrode array were higher than the banded electrode array, but this is primarily due to the reduction in electrode surface area. The different outcomes in impedance over time suggest differences in the relative contributions of the components of impedance with the two arrays.
authors.affiliation: Co-operative Research Centre for Cochlear Implant & Hearing Aid Innovation, Melbourne, Australia.
authors.forename: Elaine
authors.initials: E
authors.lastname: Saunders
authors.forename: Lawrence
authors.initials: L
authors.lastname: Cohen
authors.forename: Antje
authors.initials: A
authors.lastname: Aschendorff
authors.forename: William
authors.initials: W
authors.lastname: Shapiro
authors.forename: Michelle
authors.initials: M
authors.lastname: Knight
authors.forename: Mathias
authors.initials: M
authors.lastname: Stecker
authors.forename: Benhard
authors.initials: B
authors.lastname: Richter
authors.forename: Susan
authors.initials: S
authors.lastname: Waltzman
authors.forename: Michael
authors.initials: M
authors.lastname: Tykocinski
authors.forename: Tom
authors.initials: T
authors.lastname: Roland
authors.forename: Roland
authors.initials: R
authors.lastname: Laszig
authors.forename: Robert
authors.initials: R
authors.lastname: Cowan
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods*; D000161:Acoustic Stimulation / Q000295:instrumentation; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D003051:Cochlea / Q000000981:diagnostic imaging; D019929:Cochlear Implantation; D046508:Culture Techniques; D003638:Deafness / Q000534:rehabilitation; D004566:Electrodes; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D013701:Temporal Bone / Q000473:pathology