title: Results of Postoperative, CT-based, Electrode Deactivation on Hearing in Prelingually Deafened Adult Cochlear Implant Recipients.
abstract: OBJECTIVE
  To test the use of a novel, image-guided cochlear implant (CI) programming (IGCIP) technique on prelingually deafened, adult CI recipients.
  
  
  METHODS
  Prospective unblinded study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Twenty-six prelingually deafened adult CI recipients with 29 CIs (3 bilateral).
  
  
  METHODS
  Temporal-bone CT scans were used as input to a series of semiautomated computer algorithms which estimate the location of electrodes in reference to the modiolus. This information was used to selectively deactivate suboptimally located electrodes, i.e., those for which the distance from the electrode to the modiolus was further than a neighboring electrode to the same site. Patients used the new IGCIP program exclusively for 3-5 weeks.
  
  
  METHODS
  Minimum Speech Test Battery (MSTB), quality of life (QOL), and spectral modulation detection (SMD).
  
  
  RESULTS
  On average one-third of electrodes were deactivated. At the group level, no significant differences were noted for MSTB measures nor for QOL estimates. Average SMD significantly improved after IGCIP reprogramming, which is consistent with improved spatial selectivity. Using 95% confidence interval data for CNC, AzBio, and BKB-SIN at the individual level, 76 to 90% of subjects demonstrated equivocal or significant improvement. Ultimately 21 of 29 (72.41%) elected to keep the IGCIP map because of perceived benefit often substantiated by improvement on either MSTB, QOL, and/or SMD.
  
  
  CONCLUSIONS
  Knowledge of the geometric relationship between CI electrodes and the modiolus appears to be useful in adjusting CI maps in prelingually deafened adults. Long-term improvements may be observed resulting from improved spatial selectivity and spectral resolution.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery †Department of Electrical Engineering and Computer Science ‡Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee, U.S.A.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Labadie
authors.forename: Jack H
authors.initials: JH
authors.lastname: Noble
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Hedley-Williams
authors.forename: Linsey W
authors.initials: LW
authors.lastname: Sunderhaus
authors.forename: Benoit M
authors.initials: BM
authors.lastname: Dawant
authors.forename: René H
authors.initials: RH
authors.lastname: Gifford
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001931:Brain Mapping / Q000379:methods*; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003638:Deafness / Q000601:surgery*; D005260:Female; D006309:Hearing; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013063:Speech Discrimination Tests; D013067:Speech Perception / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods*