{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T04:46:52Z","timestamp":1785041212352,"version":"3.55.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec id=\"ab-ooi230064-4\"><jats:title>Importance<\/jats:title><jats:p>Cochlear implantation produces remarkable results in postlingual deafness, although auditory outcomes vary. Electrocochleography (ECochG) has emerged as a valuable tool for assessing the cochlear-neural substrate and evaluating patient prognosis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-5\"><jats:title>Objective<\/jats:title><jats:p>To assess whether ECochG-total response (ECochG-TR) recorded at the best-frequency electrode (BF-ECochG-TR) correlates more strongly with speech perception performance than ECochG-TR measured at the round window (RW-ECochG-TR).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This single-center cross-sectional study recruited 142 patients from July 1, 2021, to April 30, 2022, with 1-year follow-up. Exclusions included perilymph suctioning, crimped sound delivery tubes, non\u2013native English speakers, inner ear malformations, nonpatent external auditory canals, or cochlear implantation revision surgery.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-7\"><jats:title>Exposures<\/jats:title><jats:p>Cochlear implantation.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Speech perception testing, including the consonant-nucleus-consonant (CNC) words test, AzBio sentences in quiet, and AzBio sentences in noise plus 10-dB signal to noise ratio (with low scores indicating poor performance and high scores indicating excellent performance on all tests), at 6 months postoperatively; and RW-ECochG-TR and BF-ECochG-TR (measured for 250, 500, 1000, and 2000 Hz).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-9\"><jats:title>Results<\/jats:title><jats:p>A total of 109 of the 142 eligible postlingual adults (mean [SD] age, 68.7 [15.8] years; 67 [61.5%] male) were included in the study. Both BF-ECochG-TR and RW-ECochG-TR were correlated with 6-month CNC scores (BF-ECochG-TR: <jats:italic>r<\/jats:italic>\u2009=\u20090.74; 95% CI, 0.62-0.82; RW-ECochG-TR: <jats:italic>r<\/jats:italic>\u2009=\u20090.67; 95% CI, 0.54-0.76). A multivariate model incorporating age, duration of hearing loss, and angular insertion depth did not outperform BF-ECochG-TR or RW-ECochG-TR alone. The BF-ECochG-TR correlation with CNC scores was significantly stronger than the RW-ECochG-TR correlation (<jats:italic>r<\/jats:italic> difference\u2009=\u2009\u22120.18; 95% CI, \u22120.31 to \u22120.01; <jats:italic>z<\/jats:italic>\u2009=\u2009\u22122.02). More moderate correlations existed between 6-month AzBio scores in noise, Montreal Cognitive Assessment (MoCA) scores (<jats:italic>r<\/jats:italic>\u2009=\u20090.46; 95% CI, 0.29-0.60), and BF-ECochG-TR (<jats:italic>r<\/jats:italic>\u2009=\u20090.42; 95% CI, 0.22-0.58). MoCA and the interaction between BF-ECochG-TR and MoCA accounted for a substantial proportion of variability in AzBio scores in noise at 6 months (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.50; 95% CI, 0.36-0.61).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi230064-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this case series, BF-ECochG-TR was identified as having a stronger correlation with cochlear implantation performance than RW-ECochG-TR, although both measures highlight the critical role of the cochlear-neural substrate on outcomes. Demographic, audiologic, and surgical factors demonstrated weak correlations with cochlear implantation performance, and performance in noise was found to require a robust cochlear-neural substrate (BF-ECochG-TR) as well as sufficient cognitive capacity (MoCA). Future cochlear implantation studies should consider these variables when assessing performance and related interventions.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2023.2988","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T15:02:28Z","timestamp":1697727748000},"page":"1120","source":"Crossref","is-referenced-by-count":19,"title":["Improved Cochlear Implant Performance Estimation Using Tonotopic-Based Electrocochleography"],"prefix":"10.1001","volume":"149","author":[{"given":"Amit","family":"Walia","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Shew","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Varghese","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Ioerger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Lefler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Ortmann","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques A.","family":"Herzog","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Buchman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"11","key":"ooi230064r1","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1002\/ar.v295.11","article-title":"The cochlear implant: historical aspects and future prospects.","volume":"295","author":"Eshraghi","year":"2012","journal-title":"Anat Rec (Hoboken)"},{"issue":"10","key":"ooi230064r2","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1001\/jamaoto.2020.0998","article-title":"Unilateral cochlear implants for severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss: a systematic review and consensus statements.","volume":"146","author":"Buchman","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"ooi230064r3","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1001\/jamaoto.2020.1584","article-title":"Assessment of speech understanding after cochlear implantation in adult hearing aid users: a nonrandomized controlled trial.","volume":"146","author":"Buchman","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"ooi230064r4","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1001\/jamaoto.2020.2286","article-title":"Assessment of cochlear implants for adult Medicare beneficiaries aged 65 years or older who meet expanded indications of open-set sentence recognition: a multicenter nonrandomized clinical trial.","volume":"146","author":"Zwolan","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"4","key":"ooi230064r5","first-page":"445","article-title":"Residual speech recognition and cochlear implant performance: effects of implantation criteria.","volume":"20","author":"Rubinstein","year":"1999","journal-title":"Am J Otol"},{"issue":"12","key":"ooi230064r6","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1177\/000348949310201201","article-title":"Multivariate predictors of audiological success with multichannel cochlear implants.","volume":"102","author":"Gantz","year":"1993","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"5","key":"ooi230064r7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232421","article-title":"Cochlear implantation outcomes in adults: a scoping review.","volume":"15","author":"Boisvert","year":"2020","journal-title":"PLoS One"},{"issue":"4","key":"ooi230064r8","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.wjorl.2017.12.010","article-title":"Three challenges for future research on cochlear implants.","volume":"3","author":"Pisoni","year":"2018","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"issue":"3","key":"ooi230064r9","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/AUD.0000000000000630","article-title":"Residual cochlear function in adults and children receiving cochlear implants: correlations with speech perception outcomes.","volume":"40","author":"Fontenot","year":"2019","journal-title":"Ear Hear"},{"issue":"1","key":"ooi230064r10","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.1038\/s41598-022-07175-7","article-title":"Electrocochleography and cognition are important predictors of speech perception outcomes in noise for cochlear implant recipients.","volume":"12","author":"Walia","year":"2022","journal-title":"Sci Rep"},{"issue":"8","key":"ooi230064r11","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1097\/MAO.0000000000003628","article-title":"Promontory electrocochleography recordings to predict speech-perception performance in cochlear implant recipients.","volume":"43","author":"Walia","year":"2022","journal-title":"Otol Neurotol"},{"issue":"1","key":"ooi230064r12","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/MAO.0000000000000219","article-title":"Round window electrocochleography just before cochlear implantation: relationship to word recognition outcomes in adults.","volume":"35","author":"Fitzpatrick","year":"2014","journal-title":"Otol Neurotol"},{"issue":"9","key":"ooi230064r13","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.1097\/MAO.0000000000000557","article-title":"Round window electrocochleography and speech perception outcomes in adult cochlear implant subjects: comparison with audiometric and biographical information.","volume":"35","author":"McClellan","year":"2014","journal-title":"Otol Neurotol"},{"issue":"1","key":"ooi230064r14","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s10162-022-00882-y","article-title":"Cochlear health and cochlear-implant function.","volume":"24","author":"Schvartz-Leyzac","year":"2023","journal-title":"J Assoc Res Otolaryngol"},{"issue":"1-2","key":"ooi230064r15","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0378-5955(89)90089-0","article-title":"The origin of the low-frequency microphonic in the first cochlear turn of guinea-pig.","volume":"39","author":"Patuzzi","year":"1989","journal-title":"Hear Res"},{"issue":"9","key":"ooi230064r16","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1097\/MAO.0b013e31826dbc80","article-title":"Intraoperative round window recordings to acoustic stimuli from cochlear implant patients.","volume":"33","author":"Choudhury","year":"2012","journal-title":"Otol Neurotol"},{"issue":"7","key":"ooi230064r18","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1001\/jamaoto.2020.0662","article-title":"Association of patient-related factors with adult cochlear implant speech recognition outcomes: a meta-analysis.","volume":"146","author":"Zhao","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"ooi230064r19","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.915302","article-title":"Is characteristic frequency limiting real-time electrocochleography during cochlear implantation?","volume":"16","author":"Walia","year":"2022","journal-title":"Front Neurosci"},{"key":"ooi230064r20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1044\/jshd.2701.62","article-title":"Revised CNC lists for auditory tests.","volume":"27","author":"Peterson","year":"1962","journal-title":"J Speech Hear Disord"},{"issue":"1","key":"ooi230064r21","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1097\/AUD.0b013e31822c2549","article-title":"Development and validation of the AzBio sentence lists.","volume":"33","author":"Spahr","year":"2012","journal-title":"Ear Hear"},{"issue":"4","key":"ooi230064r22","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/jgs.2005.53.issue-4","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"ooi230064r23","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1177\/00034894071160S401","article-title":"In vivo estimates of the position of advanced bionics electrode arrays in the human cochlea.","volume":"197","author":"Skinner","year":"2007","journal-title":"Ann Otol Rhinol Laryngol Suppl"},{"issue":"6","key":"ooi230064r24","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1097\/MAO.0b013e3182255915","article-title":"Verification of computed tomographic estimates of cochlear implant array position: a micro-CT and histologic analysis.","volume":"32","author":"Teymouri","year":"2011","journal-title":"Otol Neurotol"},{"issue":"3","key":"ooi230064r25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0121945","article-title":"Cocor: a comprehensive solution for the statistical comparison of correlations.","volume":"10","author":"Diedenhofen","year":"2015","journal-title":"PLoS One"},{"issue":"11","key":"ooi230064r26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0048739","article-title":"Pre-, per- and postoperative factors affecting performance of postlinguistically deaf adults using cochlear implants: a new conceptual model over time.","volume":"7","author":"Lazard","year":"2012","journal-title":"PLoS One"},{"issue":"3","key":"ooi230064r27","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1097\/AUD.0b013e3182741aa7","article-title":"Factors affecting open-set word recognition in adults with cochlear implants.","volume":"34","author":"Holden","year":"2013","journal-title":"Ear Hear"},{"issue":"4","key":"ooi230064r28","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1097\/AUD.0000000000000985","article-title":"Relationship between electrocochleography, angular insertion depth, and cochlear implant speech perception outcomes.","volume":"42","author":"Canfarotta","year":"2021","journal-title":"Ear Hear"},{"key":"ooi230064r29","doi-asserted-by":"publisher","first-page":"24907","DOI":"10.1038\/srep24907","article-title":"Round-window delivery of neurotrophin 3 regenerates cochlear synapses after acoustic overexposure.","volume":"6","author":"Suzuki","year":"2016","journal-title":"Sci Rep"},{"issue":"11","key":"ooi230064r30","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1002\/ar.v295.11","article-title":"The Trk A, B, C\u2019s of neurotrophins in the cochlea.","volume":"295","author":"Green","year":"2012","journal-title":"Anat Rec (Hoboken)"},{"key":"ooi230064r31","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1104574","article-title":"Assessment of cochlear synaptopathy by electrocochleography to low frequencies in a preclinical model and human subjects.","volume":"14","author":"Haggerty","year":"2023","journal-title":"Front Neurol"},{"issue":"8","key":"ooi230064r32","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1097\/MAO.0000000000000451","article-title":"Intracochlear electrocochleography during cochlear implantation.","volume":"35","author":"Calloway","year":"2014","journal-title":"Otol Neurotol"},{"issue":"5","key":"ooi230064r33","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1177\/0194599811435895","article-title":"Electrocochleography during cochlear implantation for hearing preservation.","volume":"146","author":"Mandal\u00e0","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"4","key":"ooi230064r34","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1097\/MAO.0000000000003475","article-title":"Early hearing preservation outcomes following cochlear implantation with new slim lateral wall electrode using electrocochleography.","volume":"43","author":"Walia","year":"2022","journal-title":"Otol Neurotol"},{"key":"ooi230064r35","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3389\/fnins.2017.00291","article-title":"Intra- and postoperative electrocochleography may be predictive of final electrode position and postoperative hearing preservation. original research.","volume":"11","author":"O\u2019Connell","year":"2017","journal-title":"Front Neurosci"},{"issue":"5","key":"ooi230064r36","doi-asserted-by":"publisher","first-page":"3667","DOI":"10.1121\/10.0001304","article-title":"Speech masking release in Hybrid cochlear implant users: roles of spectral and temporal cues in electric-acoustic hearing.","volume":"147","author":"Tejani","year":"2020","journal-title":"J Acoust Soc Am"},{"issue":"10","key":"ooi230064r37","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1097\/00005537-200310000-00012","article-title":"Combining acoustic and electrical hearing.","volume":"113","author":"Gantz","year":"2003","journal-title":"Laryngoscope"},{"issue":"4","key":"ooi230064r38","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1121\/1.1687425","article-title":"Speech recognition in noise for cochlear implant listeners: benefits of residual acoustic hearing.","volume":"115","author":"Turner","year":"2004","journal-title":"J Acoust Soc Am"},{"key":"ooi230064r17","unstructured":"Walia? A, Ortmann? AJ, Lefler? S, Holden? T, Herzog? JA, Buchman? CA. Direct in vivo measurement of cochlear place coding in humans.? medRxiv. 2023:2023.04.13.23288518."}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2810849\/jamaotolaryngology_walia_2023_oi_230064_1701290182.93108.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T16:07:52Z","timestamp":1702570072000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2810849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2023.2988","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,1]]}}}