Evidence map›Paper›PMID 41243018›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Effect of early activation and perimodiolar electrodes on cochlear implant impedance.

Fida Almuhawas, Dalal Alrushaydan, Shaza Saleh, Mada Aljabr, Hassan Yalcouy, Farid Alzahrani, Abdulrahman Alsanousi, Abdulrahman Hagr

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fida AlmuhawasDepartment of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. fmuhawas@ksu.edu.sa.ORCID http://orcid.org/0009-0000-4057-4170
Dalal AlrushaydanCochlear Arabia Regional Head Quarter, Riyadh, Saudi Arabia.
Shaza SalehKing Abdullah Ear Specialist Center (KAESC), King Saud University Medical City, Riyadh, Saudi Arabia.
Mada AljabrCochlear Arabia Regional Head Quarter, Riyadh, Saudi Arabia.
Hassan YalcouyCochlear Arabia Regional Head Quarter, Riyadh, Saudi Arabia.
Farid AlzahraniDepartment of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdulrahman AlsanousiDepartment of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdulrahman HagrKing Abdullah Ear Specialist Center (KAESC), King Saud University Medical City, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCochlear implantation (CI) is a proven treatment for severe-to-profound hearing loss, yet outcomes vary widely due to individual, device, and surgical factors. Intracochlear changes, such as fibrosis and neo-ossification, influence electrode impedance and device performance, potentially affecting speech perception. PURPOSE: This study investigates the effects of early activation (EA) versus standard activation on intracochlear impedance telemetry across different electrode types (lateral vs. perimodiolar). It aims to assess whether EA reduces the impedance and improves CI outcomes.

methodsThis study involved 38 participants (54 CI ears) with Cochlear slim-straight or slim perimodiolar electrodes. Impedance telemetry was measured at four key time points, ranging from intra-operative to 12 months post-activation. Mixed-effects regression models evaluated the influence of activation timing and electrode type on impedance levels, with statistical significance determined using Bonferroni-corrected thresholds.

resultsPerimodiolar electrodes demonstrated significantly lower impedances compared to lateral electrodes, particularly in EA cases. EA consistently resulted in reduced impedances across all cochlear regions, with the greatest reductions observed in the apical and middle regions at 3-6 months (p < 0.0001). By ≥ 1 year, impedance differences between activation modes diminished but remained significant in select regions (p = 0.012).

conclusionEA, particularly with perimodiolar electrodes, optimizes the electrode-tissue interface, reducing impedance and potentially improving CI performance. These findings highlight the clinical benefits of EA in enhancing CI outcomes and support its consideration in routine CI protocols.

Indexed as

Cochlear ImplantationCochlear ImplantsElectric ImpedanceElectrodes, ImplantedAdolescentAdultAgedCochleaFemaleHumansMaleMiddle AgedSpeech PerceptionTelemetryTreatment OutcomeYoung AdultCochlear implantsEarly activationImpedancePerimodiolarSensorineural/surgerySwitch on

Identifiers

PMID41243018
PMCPMC13002729

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.