Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers

Viral Tejani; Robin Piper; Gail Murray; Nauman F. Manzoor; Sarah Mowry; Maroun Semaan; Alejandro Rivas

doi:10.1097/MAO.0000000000004361

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Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers

Journal article

Peer reviewed

Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers

Viral Tejani, Robin Piper, Gail Murray, Nauman F. Manzoor, Sarah Mowry, Maroun Semaan and Alejandro Rivas

Otology & neurotology, Vol.45(10), pp.e763-e771

12/2024

DOI: 10.1097/MAO.0000000000004361

PMID: 39514433

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Abstract

Objective Evaluate the sensitivity and financial costs of Trans-Impedance Matrix recordings, Spread of Excitation functions, and x-rays in detecting cochlear implant tip foldovers Setting Tertiary academic medical center Patients 113 ears of 108 patients Interventions Following cochlear implantation and before concluding surgery, intraoperative Trans-Impedance Matrix recordings, Spread of Excitation functions, and x-rays were conducted to evaluate presence of tip foldover. Main Outcome Measures Presence of tip foldover; recording time necessary for and costs of Trans-Impedance Matrix, spread of excitation, and x-rays. Results There were six tip foldovers. Trans-Impedance Matrix showed 100% sensitivity, 100% specificity, 100% positive predictive value, and 100% negative predicative value in detecting tip foldovers. Spread of excitation showed 29% sensitivity, 99% specificity, 67% positive predictive value, and 95% negative predicative value. Trans-Impedance Matrix recordings were completed significantly faster than spread of excitation and x-rays. Elimination of x-rays from our intraoperative workflow results in a twofold cost reduction. Conclusion Trans-Impedance Matrix recordings have potential great clinical utility in evaluating proper CI placement intraoperatively and reducing costs of surgery while not compromising patient care. Given the low tip foldover rate, a multicenter study is in progress to evaluate the sensitivity, specificity, positive predictive value, and negative predicative value of Trans-Impedance Matrix in a larger dataset. This can provide better guidance to cochlear implant clinics interested in evaluating the impact of using Trans-Impedance Matrix on patient care as well as the economics of reducing use of intraoperative imaging.

Electrophysiology

Cochlear implant

Tip foldover

Trans-Impedance Matrix

Details

Title: Subtitle: Sensitivity and Costs of Intraoperative Trans-Impedance Matrix Recordings, Spread of Excitation Functions, and X-ray Imaging in Detecting Cochlear Implant Tip Foldovers
Creators: Viral Tejani - Case Western Reserve University
Robin Piper - Case Western Reserve University
Gail Murray - Case Western Reserve University
Nauman F. Manzoor - Virginia Commonwealth University
Sarah Mowry - Case Western Reserve University
Maroun Semaan - Case Western Reserve University
Alejandro Rivas - Case Western Reserve University
Resource Type: Journal article
Publication Details: Otology & neurotology, Vol.45(10), pp.e763-e771
DOI: 10.1097/MAO.0000000000004361
PMID: 39514433
NLM abbreviation: Otol Neurotol
ISSN: 1531-7129
eISSN: 1537-4505
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Grant note: Cochlear Corporation
Omotayo Agaja, Au.D.; Nicole Besse, Au.D.; Anna Braam, Au.D.; Abby Maurer Jayack, Au.D.; and Holly Yako, Au.D. collected a majority of intraoperative data. Cochlear Corporation provided the research patch to perform Trans-Impedance Matrix recordings via Custom Sound EP
Language: English
Date published: 12/2024
Academic Unit: Otolaryngology
Record Identifier: 9984746137802771

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