Influence of cochlea implant re-implantation on speech comprehension
Victoria Gußen, Lutz Gärtner, Eugen Kludt, Max Timm, Anke Lesinski-Schiedat, Thomas Lenarz
Hannover Medical School, Department of Otolaryngology, Hannover, GermanyObjectives:
To investigate the influence of re-implantation on speech comprehension in patients with a cochlea implant (CI).
Methods:
In our clinic, 349 patients were implanted with the initial version (“V1”) of the HiRes Ultra or HiRes Ultra 3D (Advanced Bionics). Due to an implant failure, so far 142 re-implantations were necessary. We analyzed data of 31 patients, which were tested at a time where no implant failure was present before re-implantation, and which were re-implanted with the same type of the electrode array (Mid-Scala or SlimJ). Test battery was monosyllables in quiet at 65 dB SPL and speech sentence in noise (HSM sentence test at 10 dB SNR).
Furthermore, we evaluated the location of the electrode in DVT images (using Osirix MD) before and after the re-implantation and calculated the individual change in insertion angle and the cochlear coverage.
Results:
After re-implantation the speech score in quiet and in noise changed by 4.83+-14.47% (mean, standard deviation) and 5.22 +-21.8%, respectively. These changes were considered to be smaller than test-retest variation and not clinically relevant.
The mean value of the individual difference of the insertion angle is -2.96+-28.21 degrees and the average change of the cochlea coverage was 0.06+-1.39 mm.
Correlation analysis between the individual change in the electrode insertion angle and insertion depth and the change in the speech perception showed a weak trend indicating that with a deeper insertion of the electrode, the speech comprehension of the patients tended to improve. However, a small coefficient of determination (R^2) of 0.04 and the sentence tests of 0.05, which means that only 4 % of the words and 5 % of the sentences results can be explained by the change in the electrode location.
Conclusion:
Re-implantation of CI can be done safely without compromising speech recognition, which is also an important finding concerning language development in children. In cases where re-implantation resulted in a higher cochlea coverage of the electrode, speech comprehension tended to improve.

**Influence of cochlea implant re-implantation on speech comprehension**
Victoria Gußen, Lutz Gärtner, Eugen Kludt, Max Timm, Anke Lesinski-Schiedat, Thomas Lenarz
Hannover Medical School, Department of Otolaryngology, Hannover, Germany**Objectives:**
To investigate the influence of re-implantation on speech comprehension in patients with a cochlea implant (CI).
**Methods:**
In our clinic, 349 patients were implanted with the initial version (“V1”) of the HiRes Ultra or HiRes Ultra 3D (Advanced Bionics). Due to an implant failure, so far 142 re-implantations were necessary. We analyzed data of 31 patients, which were tested at a time where no implant failure was present before re-implantation, and which were re-implanted with the same type of the electrode array (Mid-Scala or SlimJ). Test battery was monosyllables in quiet at 65 dB SPL and speech sentence in noise (HSM sentence test at 10 dB SNR).
Furthermore, we evaluated the location of the electrode in DVT images (using Osirix MD) before and after the re-implantation and calculated the individual change in insertion angle and the cochlear coverage.
**Results:**
After re-implantation the speech score in quiet and in noise changed by 4.83+-14.47% (mean, standard deviation) and 5.22 +-21.8%, respectively. These changes were considered to be smaller than test-retest variation and not clinically relevant.
The mean value of the individual difference of the insertion angle is -2.96+-28.21 degrees and the average change of the cochlea coverage was 0.06+-1.39 mm.
Correlation analysis between the individual change in the electrode insertion angle and insertion depth and the change in the speech perception showed a weak trend indicating that with a deeper insertion of the electrode, the speech comprehension of the patients tended to improve. However, a small coefficient of determination (R^2) of 0.04 and the sentence tests of 0.05, which means that only 4 % of the words and 5 % of the sentences results can be explained by the change in the electrode location.
**Conclusion:**
Re-implantation of CI can be done safely without compromising speech recognition, which is also an important finding concerning language development in children. In cases where re-implantation resulted in a higher cochlea coverage of the electrode, speech comprehension tended to improve.

Influence of cochlea implant re-implantation on speech comprehension

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,