Citations 2
Multi‐Frequency Electrocochleography Results in Fewer Drop Alarms During Cochlear Implant Insertion
Espahbodi, Mana , Syed, Ali, Tu, Alex, Seidman, Michael D. , Danner, Christopher J., Allen, Kyle P., Bartels, Loren J., Ahsan, Syed F. , Voelker, Courtney C. J. , Deep, Nicholas L. , Chiffer, Rebecca C., Elrakhawy, Mohamed, Miller, Matthew W., Lin, Harrison W., Djalilian, Hamid R. , Angeli, Simon I., Kim, H J, Widick, Mark H., Stidham, Katrina R. , Patel, Neil S. , Koka, Kanthaiah , Hunter, Jacob B , Djalilian, Hamid R , Stidham, Katrina R , Gurgel, Richard Klaus , Doerfer, Karl W , Harris, Michael S , Danner, Christopher, Bartels, Loren Jay, Hunter, Jacob B. , Michaelides, Elias M. , Miller, Matthew W, Vivas, Esther , Angeli, Simón I., Hoa, Michael , Harris, Michael S.
The Laryngoscope | May 5, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
ABSTRACT Objective To evaluate intracochlear electrocochleography (ECochG) amplitude parameters during cochlear implantation (CI) using a novel multi‐frequency ECochG algorithm. Methods A multi‐institutional, prospective cohort study was performed at 18 high‐volume CI centers. The inclusion criteria were adults with sensorineural hearing loss and audiometric thresholds of ≤ 90 dB hearing level at 500 Hz undergoing CI with Advanced Bionics (Valencia, CA) Ultra 3D devices between 2024 and 2025. ECochG recordings were performed with simultaneous multi‐frequency stimulation of four frequencies between 125 and 4000 Hz during cochlear implant insertion. Concurrent multi‐frequency recording allowed extraction of amplitude and phase of each frequency individually. Post hoc analysis was performed to determine the difference in the number of drop alarms between single‐ and multi‐frequency ECochG. An ECochG amplitude drop of 6 dB was defined as a drop alarm. Insertion track patterns were compared between single‐ and multi‐frequency ECochG. Results One hundred ninety‐five ears were included. Mean number of drop alarms for the single‐frequency algorithm was 1.72 (95% CI: 1.52, 1.92; median 1) compared to 0.42 (95% CI: 0.31, 0.53; median 0) for multi‐frequency; p < 0.001. The number of Type C patterns (rise in amplitude during insertion followed by a drop) decreased with the multi‐frequency ECochG algorithm compared to the single‐frequency ECochG algorithm. The number of Type D patterns (no‐response) decreased, indicating that multi‐frequency ECochG generated more responses across the cochlea than single‐frequency ECochG. Conclusions A novel multi‐frequency ECochG algorithm during CI is associated with fewer drop alarms and altered insertion track patterns, which may provide a more accurate assessment of the cochlear microenvironment. Level of Evidence 3.
Catchment Profile of Large Cochlear Implant Centers in the United States
Nassiri, Ashley M. , Holcomb, Meredith A. , Perkins, Elizabeth L. , Bucker, Andrea L., Prentiss, Sandra , Welch, Christopher M. , Andresen, Nick S., Valenzuela, Carla V. , Wick, Cameron C. , Angeli, Simón I., Sun, Daniel Q. , Bowditch, Stephen P., Brown, Kevin D. , Zwolan, Teresa A. , Haynes, David S. , Saoji, Aniket A. , Carlson, Matthew L. , Perkins, Elizabeth L
Otolaryngology–Head and Neck Surgery | January 18, 2022 | Volume: 167 | Issue: 3 | Pages: 545-551
ObjectiveTo characterize the catchment area and patient profile of large cochlear implant (CI) centers in the United States.Study DesignMulti‐institutional retrospective case series.SettingTertiary referral CI centers.MethodsPatients who underwent CI surgery at 7 participating CI centers between 2015 and 2020 were identified. Patients’ residential zip codes were used to approximate travel distances and urban vs rural residential areas.ResultsOver the 6‐year study period (2015‐2020), 6313 unique CI surgical procedures occurred (4529 adult, 1784 pediatric). Between 2015 and 2019, CI procedures increased by 43%. Patients traveled a median 52 miles (interquartile range, 21‐110) each way; patients treated at rural CI centers traveled greater distances vs those treated at urban centers (72 vs 46 miles, P <. 001). Rural residents represented 61% of the patient population and traveled farther than urban residents (73 vs 24 miles, P <. 001). Overall, 91% of patients lived within a 200‐mile radius of the institution, while 71% lived within a 100‐mile radius. In adults, multiple regression analysis redemonstrated an association between greater travel distances and (1) older age at the time of CI and (2) residential rural setting (both P <. 001, r2 = 0.2).ConclusionsWhile large CI centers serve geographically dispersed populations, most patients reside within a 200‐mile radius. Strategies to expand CI utilization may leverage remote programming, telemedicine, and strategic placement of new centers and satellite clinics to ameliorate travel burden.