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Effects of the Clarion Electrode Positioning System on Auditory Thresholds and Comfortable Loudness Levels in Pediatric Patients With Cochlear Implants
Gail S. Donaldson, PhD;
Michael D. Peters, MD;
Melisa R. Ellis, MA;
Barbara J. Friedman, MS;
Samuel C. Levine, MD;
Franklin L. Rimell, MD
Arch Otolaryngol Head Neck Surg. 2001;127:956-960.
Objective To evaluate the effects of using the Electrode Positioning System on
psychophysical auditory thresholds, most comfortable loudness levels, and
electric auditory brainstem response (EABR) thresholds in children with the
Clarion version 1.2 cochlear implant.
Design Retrospective analysis.
Setting Academic tertiary care center.
Patients and Methods Clinical records of a series of 25 children who received the Clarion
version 1.2 cochlear implant at the University of Minnesota, Minneapolis,
between January 1997 and August 1999 were examined. Measures evaluated were
psychophysical thresholds (T-levels) and most comfortable loudness levels
(M-levels) obtained at the 3-month posthookup audiologic evaluation and EABR
thresholds obtained during implant surgery. Relevant threshold measures were
available for 24 patients, 11 of whom had received the Clarion spiral electrode
and electrode positioner (EP group) and 13 of whom had received the spiral
electrode without positioner (non-EP group). The 3 measures (T-levels, M-levels,
and EABR thresholds) were compared across groups. In addition, EABR thresholds
were compared with T-levels and M-levels within groups.
Results Mean T-levels and M-levels were significantly lower for the EP group
than for the non-EP group, and interpatient variability for these measures
was considerably smaller in the EP group. Electric auditory brainstem response
thresholds were not significantly different for EP vs non-EP patients; however,
EABR data were available for only a few non-EP patients.
Conclusions Use of the electrode positioner results in lower T-levels and M-levels
in children with the Clarion version 1.2 cochlear implant, consistent with
results of previous studies in adults, and reduces across-patient variability
for these measures. It is unclear from the present data whether use of the
electrode positioner systematically reduces intraoperative EABR thresholds.
From the Department of Otolaryngology, University of Minnesota School
of Medicine, Minneapolis.
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