{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:28:50Z","timestamp":1792531730934,"version":"4.5.0"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Residual hearing in cochlear implant (CI) candidates requires the functional integrity of the nerve in particular regions of the cochlea. Nerve activity can be elicited as electrically evoked compound action potentials (ECAP) after cochlear implantation. We hypothesize that ECAP thresholds depend on preoperative residual hearing ability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In a retrospective study, we analyzed 84 adult cochlear implant users who had received a Nucleus<jats:sup>\u00ae<\/jats:sup> CI632 Slim Modiolar Electrode and who preoperatively had had residual hearing. Inclusion criteria were severe to profound hearing loss with preoperative measurable hearing in the ear to receive the implant, postlingual hearing loss, German as native language and correct placement of the electrode, inserted completely into the scala tympani. Electrically evoked compound action potential (ECAP) was recorded intraoperatively. The angular insertion was measured for each electrode contact from postoperative computed tomography to estimate the corresponding spiral ganglion frequency. Pure-tone audiometry and allocated ECAP thresholds were tested to investigate possible correlation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average of hearing thresholds, tested at 0.5, 1, 2, and 4\u2009kHz (4FPTA) was 82\u2009\u00b1\u200918 (range 47\u2013129) dB HL. The success rate for recording ECAP thresholds was 96.9%. For all comparable pure-tone frequencies (1, 2, 4, and 8\u2009kHz), there was significant correlation between preoperative hearing levels and intraoperative ECAP thresholds (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Higher hearing thresholds are associated with increased ECAP thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In CI candidates with adequate residual hearing, intraoperative electrophysiological measurement records lower thresholds. This outcome may be explained by the neural survival density of the peripheral system, with less neural degeneration.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnhum.2023.1125747","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T04:32:47Z","timestamp":1696307567000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Electrically evoked compound action potentials in cochlear implant users with preoperative residual hearing"],"prefix":"10.3389","volume":"17","author":[{"given":"Tim","family":"Liebscher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Hornung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hoppe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1159\/000480345","article-title":"Clinical investigation of the nucleus slim modiolar electrode","volume":"22","author":"Aschendorff","year":"2017","journal-title":"Audiol. Neurotol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1177\/1084713810375249","article-title":"Probing the electrode-neuron interface with focused cochlear implant stimulation","volume":"14","author":"Bierer","year":"2010","journal-title":"Trends Amplif."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1159\/000343189","article-title":"Factors affecting auditory performance of postlinguistically deaf adults using cochlear implants: an update with 2251 patients","volume":"18","author":"Blamey","year":"2012","journal-title":"Audiol. Neurotol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.heares.2008.03.006","article-title":"Current focusing and steering: modeling, physiology, and psychophysics","volume":"242","author":"Bonham","year":"2008","journal-title":"Hear. Res."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1159\/000095613","article-title":"Comparison of round window and cochleostomy approaches with a prototype hearing preservation electrode","volume":"11","author":"Briggs","year":"2006","journal-title":"Audiol. Neurotol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s10162-020-00773-0","article-title":"Evaluating and comparing Behavioural and electrophysiological estimates of neural health in cochlear implant users","volume":"22","author":"Brochier","year":"2021","journal-title":"JARO"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1121\/1.399716","article-title":"Electrically evoked whole-nerve action potentials: data from human cochlear implant users","volume":"88","author":"Brown","year":"1990","journal-title":"J. Acoust. Soc. Am."},{"key":"ref8","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."},{"key":"ref9","year":"2020"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/s0378-5955(03)00096-0","article-title":"Spatial spread of neural excitation in cochlear implant recipients: comparison of improved ECAP method and psychophysical forward masking","volume":"179","author":"Cohen","year":"2003","journal-title":"Hear. Res."},{"key":"ref11","first-page":"859","article-title":"Improved and simplified methods for specifying positions of the electrode bands of a cochlear implant array","volume":"17","author":"Cohen","year":"1996","journal-title":"Am. J. Otolaryngol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/AUD.0000000000000495","article-title":"Use of electrically evoked compound action potentials for Cochlear implant fitting: a systematic review","volume":"39","author":"de Vos","year":"2018","journal-title":"Ear Hear."},{"key":"ref13","year":"1995"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000095611","article-title":"The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes","volume":"11","author":"Escud\u00e9","year":"2006","journal-title":"Audiol. Neurotol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/MAO.0000000000000219","article-title":"Round window electrocochleography just prior to cochlear implantation: relationship to word recognition outcomes in adults","volume":"35","author":"Fitzpatrick","year":"2014","journal-title":"Otol. Neurotol."},{"key":"ref16","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."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3193","DOI":"10.1007\/s00405-014-3352-4","article-title":"Estimation of insertion depth angle based on cochlea diameter and linear insertion depth: a prediction tool for the CI422","volume":"272","author":"Franke-Trieger","year":"2015","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1097\/00129492-200307000-00009","article-title":"Choice of ear for cochlear implantation: the effect of history and residual hearing on predicted postoperative performance","volume":"24","author":"Friedland","year":"2003","journal-title":"Otol. Neurotol."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1097\/AUD.0b013e31827e8163","article-title":"Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments","volume":"34","author":"Gifford","year":"2013","journal-title":"Ear Hear."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1097\/mao.0b013e31818f57ab","article-title":"Spread of excitation measurements for the detection of electrode array foldovers","volume":"30","author":"Grolman","year":"2009","journal-title":"Otol. Neurotol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2331216519833567","DOI":"10.1177\/2331216519833567","article-title":"Monitoring of the inner ear function during and after cochlear implant insertion using electrocochleography","volume":"23","author":"Haumann","year":"2019","journal-title":"Trends Hear."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1097\/AUD.0000000000001244","article-title":"Postlingually deafened adult cochlear implant users with prolonged recovery from neural adaptation at the level of the auditory nerve tend to have poorer speech perception performance","volume":"43","author":"He","year":"2022","journal-title":"Ear Hear."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"339","DOI":"10.3389\/fnins.2017.00339","article-title":"The electrically evoked compound action potential: from laboratory to clinic","volume":"11","author":"He","year":"2017","journal-title":"Front. Neurosci."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1007\/s00405-020-05893-0","article-title":"Outcomes for a clinically representative cohort of hearing - impaired adults using the nucleus \u00ae CI532 cochlear implant","volume":"277","author":"Hey","year":"2020","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1080\/14670100.2018.1544684","article-title":"Objective, audiological and quality of life measures with the CI532 slim modiolar electrode","volume":"20","author":"Hey","year":"2019","journal-title":"Cochlear Implants Int."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"233121651875528","DOI":"10.1177\/2331216518755288","article-title":"Current profile of adults presenting for preoperative cochlear implant evaluation","volume":"22","author":"Holder","year":"2018","journal-title":"Trends Hear."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1097\/MAO.0000000000000730","article-title":"Audiometry-based screening procedure for cochlear implant candidacy","volume":"36","author":"Hoppe","year":"2015","journal-title":"Otol. Neurotol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1007\/s00106-019-0648-0","article-title":"Maximum preimplantation monosyllabic score as predictor of cochlear implant outcome","volume":"67","author":"Hoppe","year":"2019","journal-title":"HNO"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"E940","DOI":"10.1002\/lary.28771","article-title":"Cochlear implantation in candidates with moderate-to-severe hearing loss and poor speech perception","volume":"131","author":"Hoppe","year":"2021","journal-title":"Laryngoscope"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1097\/MAO.0000000000000367","article-title":"Performance outcomes for borderline cochlear implant recipients with substantial preoperative residual hearing","volume":"35","author":"Hughes","year":"2014","journal-title":"Otol. Neurotol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1084713813480857","article-title":"A systematic review of electric-acoustic stimulation: device fitting ranges, outcomes, and clinical fitting practices","volume":"17","author":"Incerti","year":"2013","journal-title":"Trends Amplif."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s00405-017-4842-y","article-title":"The influence of cochlear morphology on the final electrode array position","volume":"275","author":"Ketterer","year":"2018","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"7043","DOI":"10.3390\/ijerph17197043","article-title":"Electrocochleography in cochlear implant users with residual acoustic hearing: a systematic review","volume":"17","author":"Kim","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/MAO.0b013e318171972f","article-title":"Performance groups in adult cochlear implant users: speech perception results from 1984 until today","volume":"29","author":"Krueger","year":"2008","journal-title":"Otol. Neurotol."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e207","DOI":"10.1097\/AUD.0000000000000163","article-title":"The relationship between insertion angles, default frequency allocations, and spiral ganglion place pitch in cochlear implants","volume":"36","author":"Landsberger","year":"2015","journal-title":"Ear Hear."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.anorl.2011.06.001","article-title":"Understanding the deafened brain: implications for cochlear implant rehabilitation","volume":"129","author":"Lazard","year":"2012","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4437","DOI":"10.1038\/s41598-021-83225-w","article-title":"Three-dimensional tonotopic mapping of the human cochlea based on synchrotron radiation phase-contrast imaging","volume":"11","author":"Li","year":"2021","journal-title":"Sci. Rep."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/J.ZEMEDI.2020.05.004","article-title":"Electrode translocations in perimodiolar cochlear implant electrodes: audiological and electrophysiological outcome","volume":"31","author":"Liebscher","year":"2021","journal-title":"Z. Med. Phys."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1007\/s10162-011-0283-2","article-title":"Age-related primary cochlear neuronal degeneration in human temporal bones","volume":"12","author":"Makary","year":"2011","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e543","DOI":"10.1097\/MAO.0000000000001873","article-title":"Earphone and aided word recognition differences in Cochlear implant candidates","volume":"39","author":"McRackan","year":"2018","journal-title":"Otol. Neurotol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e934","DOI":"10.1097\/MAO.0000000000002790","article-title":"Comparison of perimodiolar electrodes: imaging and electrophysiological outcomes","volume":"41","author":"Mewes","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1097\/MAO.0000000000000766","article-title":"Electrophysiological detection of intracochlear scalar changing perimodiolar cochlear implant electrodes: a blinded study","volume":"36","author":"Mittmann","year":"2015","journal-title":"Otol. Neurotol."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"037","DOI":"10.1055\/s-0032-1333150","article-title":"Cochlear dead regions in adults and children: diagnosis and clinical implications","volume":"34","author":"Moore","year":"2013","journal-title":"Semin. Hear."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"257","DOI":"10.3109\/14992027.2014.969410","article-title":"Intraoperative findings on ECAP-measurement: Normal or special case?","volume":"54","author":"M\u00fcller","year":"2015","journal-title":"Int. J. Audiol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/J.ZEMEDI.2020.07.002","article-title":"Intraoperatives tip-foldover-screening mittels spread of excitation messungen","volume":"31","author":"M\u00fcller","year":"2021","journal-title":"Z. Med. Phys."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"918","DOI":"10.3766\/jaaa.18052","article-title":"Intraoperative electrically evoked compound action potential (ECAP) measurements in traditional and hearing preservation cochlear implantation","volume":"30","author":"Nassiri","year":"2019","journal-title":"JAAA"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1002\/lary.25219","article-title":"Ganglion cell populations in normal and pathological human cochleae. Implications for cochlear implantation","volume":"125","author":"Otte","year":"1978","journal-title":"Laryngoscope"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.heares.2016.01.002","article-title":"Reduction in spread of excitation from current focusing at multiple cochlear locations in cochlear implant users","volume":"333","author":"Padilla","year":"2016","journal-title":"Hear. Res."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.heares.2006.03.006","article-title":"Effect of interphase gap and pulse duration on electrically evoked potentials is correlated with auditory nerve survival","volume":"215","author":"Prado-Guitierrez","year":"2006","journal-title":"Hear. Res."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s10162-013-0440-x","article-title":"Auditory-nerve responses to varied inter-phase gap and phase duration of the electric pulse stimulus as predictors for neuronal degeneration","volume":"15","author":"Ramekers","year":"2014","journal-title":"JARO"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1159\/000486409","article-title":"Hearing preservation with the slim modiolar electrode nucleus CI532\u00ae cochlear implant: a preliminary experience","volume":"22","author":"Ramos-Mac\u00edas","year":"2018","journal-title":"Audiol. Neurotol."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1682\/JRRD.2007.08.0119","article-title":"Considerations for design of future cochlear implant electrode arrays: electrode array stiffness, size, and depth of insertion","volume":"45","author":"Rebscher","year":"2008","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"3262","DOI":"10.3390\/jcm12093262","article-title":"Extended preoperative audiometry for outcome prediction and risk analysis in patients receiving cochlear implants","volume":"12","author":"Rieck","year":"2023","journal-title":"J. Clin. Med."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-017-04899-9","article-title":"Human Cochlear histopathology reflects clinical signatures of primary neural degeneration","volume":"7","author":"Sagers","year":"2017","journal-title":"Sci. Rep."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s10162-020-00749-0","article-title":"Effects of electrode location on estimates of neural health in humans with cochlear implants","volume":"21","author":"Schvartz-Leyzac","year":"2020","journal-title":"JARO"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1097\/MAO.0000000000002617","article-title":"Slim, modiolar cochlear implant electrode: Melbourne experience and comparison with the contour perimodiolar electrode","volume":"41","author":"Shaul","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref57","doi-asserted-by":"crossref","DOI":"10.1097\/AUD.0000000000001389","article-title":"The relationship between cochlear implant speech perception outcomes and electrophysiological measures of the electrically evoked compound action potential","volume-title":"Ear Hear Adv.","author":"Skidmore","year":"2023"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1097\/AUD.0000000000000916","article-title":"Prediction of the functional status of the cochlear nerve in individual cochlear implant users using machine learning and electrophysiological measures","volume":"42","author":"Skidmore","year":"2021","journal-title":"Ear Hear."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1097\/AUD.0b013e3181ec5d95","article-title":"Electrical compound action potentials recorded with automated neural response telemetry: threshold changes as a function of time and electrode position","volume":"32","author":"Spivak","year":"2011","journal-title":"Ear Hear."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1007\/s10162-007-0076-9","article-title":"Frequency map for the human cochlear spiral ganglion: implications for cochlear implants","volume":"8","author":"Stakhovskaya","year":"2007","journal-title":"JARO"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1097\/AUD.0b013e31806dc1d1","article-title":"Clinical results of AutoNRT,TM a completely automatic ECAP recording system for cochlear implants","volume":"28","author":"Van Dijk","year":"2007","journal-title":"Ear Hear."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"394687","DOI":"10.1155\/2015\/394687","article-title":"Modeling of auditory neuron response thresholds with cochlear implants","volume":"2015","author":"Venail","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"ref63","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."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"4439","DOI":"10.1523\/JNEUROSCI.3238-20.2021","article-title":"Primary neural degeneration in noise-exposed human cochleas: correlations with outer hair cell loss and word-discrimination scores","volume":"41","author":"Wu","year":"2021","journal-title":"J. Neurosci."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/s0196-0709(00)80112-x","article-title":"Cochlear view: postoperative radiography for cochlear implantation","volume":"21","author":"Xu","year":"2000","journal-title":"Am. J. Otolaryngol."}],"container-title":["Frontiers in Human Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2023.1125747\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T04:32:50Z","timestamp":1696307570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2023.1125747\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,2]]},"references-count":65,"alternative-id":["10.3389\/fnhum.2023.1125747"],"URL":"https:\/\/doi.org\/10.3389\/fnhum.2023.1125747","relation":{},"ISSN":["1662-5161"],"issn-type":[{"value":"1662-5161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,2]]},"article-number":"1125747"}}