title: Modiolar coiling, electrical thresholds, and speech perception after cochlear implantation using the nucleus contour advance electrode with the advance off stylet technique.
abstract: OBJECTIVE
  Perimodiolar electrode arrays were developed in an attempt to improve stimulation of specific neural populations and to decrease electrical thresholds, thereby decreasing power consumption. Postoperative radiographs show that coiling of the arrays is variable. Our previous study explored the relationship between the angle of coiling, threshold levels, and functional outcomes using the Nucleus Contour electrode array. This study compares coiling angle, electrical threshold levels, and speech perception measures with the Nucleus Contour Advance electrode array implanted using the new advance off stylet technique versus the Nucleus Contour electrode array implanted using the standard technique.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Forty-two adults and children with normal cochlear anatomy implanted with the Nucleus CI24RCA electrode using the advance off stylet technique with at least 1-year follow-up.
  
  
  METHODS
  Therapeutic.
  
  
  METHODS
  Computer-aided radiographic analysis of perimodiolar electrode placement, electrical threshold measurements, and speech perception outcome measures at 1 year postimplantation.
  
  
  RESULTS
  The degree of modiolar coiling was tighter using the new electrode and technique in comparison with standard insertion technique using the Nucleus Contour electrode array. The tighter coiling tended to result in higher electrical thresholds. Lower speech perception outcome measures tended to correlate with a higher degree of coiling.
  
  
  CONCLUSIONS
  The Nucleus Contour Advance electrode array combined with the advance off stylet technique resulted in a more consistent perimodiolar position. However, the tighter coiling resulted in statistically significant increased electrical thresholds and decreased speech perception outcomes. This finding may be secondary to multiple factors, not just coiling angle.
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, New York, New York, USA.
authors.forename: Tina C
authors.initials: TC
authors.lastname: Huang
authors.forename: Shari D
authors.initials: SD
authors.lastname: Reitzen
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Marrinan
authors.forename: Susan B
authors.initials: SB
authors.lastname: Waltzman
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Roland
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013067:Speech Perception; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome