ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2024
Identifying Slim Modiolar Electrode Tip Fold-Over With Intracochlear Electrocochleography.
Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Estimating Performance Using Tonotopic Measurements of Intracochlear Electrocochleography: Comparison of Lateral Wall and Perimodiolar Arrays.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Micro-CT Evaluation of Robot-Assisted Insertion of CI632 Implant in Human Cadaveric Temporal Bones.The Laryngoscope · 2026Article
- Comparing Slim Straight and Slim Perimodiolar Electrode Arrays for Cochlear Implantation: Hearing Results and Risks-A Systematic Review (2015-2025).Audiology research · 2026Review
- Transimpedance Matrix Measurement (TIM) Parameters Evaluation for the Assessment of Cochlear Implant Electrode Placement and Modiolar Proximity in Children.Biomedicines · 2025Article
- Validating an Evoked Potential Platform for Electrocochleography During Cochlear Implantation.The Laryngoscope · 2025Article
- ZH-ECochG Bode Plot: A Novel Approach to Visualize Electrocochleographic Data in Cochlear Implant Users.Journal of clinical medicine · 2024Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo evaluate the predictive value of intracochlear electrocochleography (ECochG) for identifying tip fold-over during cochlear implantation (CI) using the slim modiolar electrode (SME) array. STUDY
designProspective cohort study.
settingTertiary referral center.
methodsFrom July 2022 to June 2023, 142 patients, including adults and children, underwent intracochlear ECochG monitoring during and after SME placement. Tone-bursts were presented from 250 Hz to 2 kHz at 108 to 114 dB HL. A fast Fourier transform (FFT) allowed for frequency-specific evaluation of ECochG response. ECochG patterns during insertion and postinsertion were evaluated using sensitivity and specificity analysis to predict tip fold-over. Intraoperative plain radiographs served as a reference standard.
resultsFifteen tip fold-over cases occurred (10.6%) with significant ECochG response (>2 µV). Sixty-one cases without tip fold-over occurred (43.0%) with significant ECochG response. All tip fold-overs had both a nontonotopic postinsertion sweep and nonrobust active insertion pattern. No patients with robust insertion or tonotopic sweep patterns had tip fold-over. Sensitivity of detecting tip fold-over when having both nonrobust insertion and nontonotopic sweep patterns was 100% (95% confidence inteval [CI] 78.2%-100%), specificity was 68.9% (95% CI 55.7%-80.1%), and the overall accuracy was 72.0% (95% CI 60.5%-81.7%).
conclusionIntracochlear ECochG monitoring during cochlear implantation with the SME can be a valuable tool for identifying properly positioned electrode arrays. In cases where ECochG patterns are nonrobust on insertion and nontonotopic for electrode sweeps, there may be a concern for tip fold-over, and intraoperative imaging is necessary to confirm proper insertion.
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