Hearing Preservation in Cochlear Implantation Surgery

NCT ID: NCT07146841

Last Updated: 2025-08-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-29

Study Completion Date

2027-01-01

Brief Summary

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In order to preserve the residual hearing in patients with sensorineural hearing loss (SNHL) receiving a cochlear implant (CI), the insertion trauma to the delicate and microscopic structures of the cochlea needs to be minimized. The surgical procedure starts with the conventional mastoidectomy-posterior tympanotomy (MPT) approach to the middle ear, and is followed by accessing the cochlea, with either a cochleostomy (CO) or via the round window (RW). Both techniques have their benefits and disadvantages. Another aspect is the design of the electrode array. There are fundamentally two different designs: a \*straight\* lateral wall lying electrode array (LW), or a \*pre-curved\* perimodiolar cochlear lying electrode array (PM). Interestingly, until now, the best surgical approach and type of implant is unknown. Our hypothesis is that the combination of a RW approach and a LW lying electrode array minimizes insertion trauma, leading to better hearing outcome for SNHL patients.

Detailed Description

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Conditions

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Sensorineural Hearing Loss

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Randomized controlled single-blind trial consisting of four groups: I: RW and LW, II: RW and PM, III: CO and LW and IV: CO and PM.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group 1: RW and LW

Combination of round window insertion and lateral wall electrode array

Group Type OTHER

Round window insertion

Intervention Type PROCEDURE

Insertion of the electrode array via the round window.

Lateral wall array

Intervention Type DEVICE

Lateral wall electrode array from Advanced Bionics.

Group 2: RW and PM

Combination of round window insertion and perimodiolar electrode array

Group Type OTHER

Round window insertion

Intervention Type PROCEDURE

Insertion of the electrode array via the round window.

Periomodiolar electrode array

Intervention Type DEVICE

Perimodiolar MidScala electrode array from Advanced Bionics.

Group 3: CO and LW

Combination of cochleostomie insertion and lateral wall electrode array

Group Type OTHER

Cochleostomy insertion

Intervention Type PROCEDURE

Insertion of the electrode array via cochleostomy.

Lateral wall array

Intervention Type DEVICE

Lateral wall electrode array from Advanced Bionics.

Group 4: CO + PM

Combination of cochleostomy insertion and perimodiolar electrode array

Group Type OTHER

Cochleostomy insertion

Intervention Type PROCEDURE

Insertion of the electrode array via cochleostomy.

Periomodiolar electrode array

Intervention Type DEVICE

Perimodiolar MidScala electrode array from Advanced Bionics.

Interventions

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Round window insertion

Insertion of the electrode array via the round window.

Intervention Type PROCEDURE

Cochleostomy insertion

Insertion of the electrode array via cochleostomy.

Intervention Type PROCEDURE

Lateral wall array

Lateral wall electrode array from Advanced Bionics.

Intervention Type DEVICE

Periomodiolar electrode array

Perimodiolar MidScala electrode array from Advanced Bionics.

Intervention Type DEVICE

Other Intervention Names

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Round window cochleostomy Perimodiolar array

Eligibility Criteria

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Inclusion Criteria

* Severe hearing loss, CI candidate
* 18 years of age or older
* normal function of middle ear (i.e. no acute middle ear infections)
* dutch language proficiency
* choice for Advanced Bionics implant

Exclusion Criteria

* prior otologic surgery in the implanted ear (excluding tympanostomy tube placement)
* inner ear malformation present in the ear to be implanted (i.e. ossification, Mondini malformation)
* retrocochlear pathology present in the auditory system to be implanted
* neurocognitive disorders
* sudden deafness
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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UMC Utrecht

OTHER

Sponsor Role lead

Responsible Party

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Prof Dr HGXM Thomeer MD PhD

MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hans GXM Thomeer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

UMC Utrecht

Locations

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University Medical Center Utrecht

Utrecht, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Imogen AML van Beurden, MD

Role: CONTACT

+31887555555

Facility Contacts

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Hans GXM Thomeer, MD, PhD

Role: primary

+310887555555

Role: backup

References

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Rask-Andersen H, Erixon E, Kinnefors A, Lowenheim H, Schrott-Fischer A, Liu W. Anatomy of the human cochlea--implications for cochlear implantation. Cochlear Implants Int. 2011 May;12 Suppl 1:S8-13. doi: 10.1179/146701011X13001035752174.

Reference Type BACKGROUND
PMID: 21756464 (View on PubMed)

Escude B, James C, Deguine O, Cochard N, Eter E, Fraysse B. The size of the cochlea and predictions of insertion depth angles for cochlear implant electrodes. Audiol Neurootol. 2006;11 Suppl 1:27-33. doi: 10.1159/000095611. Epub 2006 Oct 6.

Reference Type BACKGROUND
PMID: 17063008 (View on PubMed)

Avci E, Nauwelaers T, Hamacher V, Kral A. Three-Dimensional Force Profile During Cochlear Implantation Depends on Individual Geometry and Insertion Trauma. Ear Hear. 2017 May/Jun;38(3):e168-e179. doi: 10.1097/AUD.0000000000000394.

Reference Type BACKGROUND
PMID: 28045786 (View on PubMed)

Snels C, IntHout J, Mylanus E, Huinck W, Dhooge I. Hearing Preservation in Cochlear Implant Surgery: A Meta-Analysis. Otol Neurotol. 2019 Feb;40(2):145-153. doi: 10.1097/MAO.0000000000002083.

Reference Type BACKGROUND
PMID: 30624395 (View on PubMed)

Fan X, Xia M, Wang Z, Zhang H, Liu C, Wang N, Hou L, Li C, Xu A. Comparison of electrode position between round window and cochleostomy inserting approaches among young children: a cone-beam computed tomography study. Acta Otolaryngol. 2018 Sep;138(9):815-821. doi: 10.1080/00016489.2018.1478127. Epub 2018 Jun 23.

Reference Type BACKGROUND
PMID: 29936898 (View on PubMed)

Wanna GB, Noble JH, Gifford RH, Dietrich MS, Sweeney AD, Zhang D, Dawant BM, Rivas A, Labadie RF. Impact of Intrascalar Electrode Location, Electrode Type, and Angular Insertion Depth on Residual Hearing in Cochlear Implant Patients: Preliminary Results. Otol Neurotol. 2015 Sep;36(8):1343-8. doi: 10.1097/MAO.0000000000000829.

Reference Type BACKGROUND
PMID: 26176556 (View on PubMed)

Wanna GB, Noble JH, Carlson ML, Gifford RH, Dietrich MS, Haynes DS, Dawant BM, Labadie RF. Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes. Laryngoscope. 2014 Nov;124 Suppl 6(0 6):S1-7. doi: 10.1002/lary.24728. Epub 2014 May 30.

Reference Type BACKGROUND
PMID: 24764083 (View on PubMed)

Havenith S, Lammers MJ, Tange RA, Trabalzini F, della Volpe A, van der Heijden GJ, Grolman W. Hearing preservation surgery: cochleostomy or round window approach? A systematic review. Otol Neurotol. 2013 Jun;34(4):667-74. doi: 10.1097/MAO.0b013e318288643e.

Reference Type BACKGROUND
PMID: 23640087 (View on PubMed)

Gfeller KE, Olszewski C, Turner C, Gantz B, Oleson J. Music perception with cochlear implants and residual hearing. Audiol Neurootol. 2006;11 Suppl 1:12-5. doi: 10.1159/000095608. Epub 2006 Oct 6.

Reference Type BACKGROUND
PMID: 17063005 (View on PubMed)

Buechner A, Brendel M, Krueger B, Frohne-Buchner C, Nogueira W, Edler B, Lenarz T. Current steering and results from novel speech coding strategies. Otol Neurotol. 2008 Feb;29(2):203-7. doi: 10.1097/mao.0b013e318163746.

Reference Type BACKGROUND
PMID: 18223448 (View on PubMed)

Gifford RH, Dorman MF, Skarzynski H, Lorens A, Polak M, Driscoll CL, Roland P, Buchman CA. Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments. Ear Hear. 2013 Jul-Aug;34(4):413-25. doi: 10.1097/AUD.0b013e31827e8163.

Reference Type BACKGROUND
PMID: 23446225 (View on PubMed)

Skarzynski H, Lorens A, Matusiak M, Porowski M, Skarzynski PH, James CJ. Cochlear implantation with the nucleus slim straight electrode in subjects with residual low-frequency hearing. Ear Hear. 2014 Mar-Apr;35(2):e33-43. doi: 10.1097/01.aud.0000444781.15858.f1.

Reference Type BACKGROUND
PMID: 24556970 (View on PubMed)

Eshraghi AA, Nazarian R, Telischi FF, Rajguru SM, Truy E, Gupta C. The cochlear implant: historical aspects and future prospects. Anat Rec (Hoboken). 2012 Nov;295(11):1967-80. doi: 10.1002/ar.22580. Epub 2012 Oct 8.

Reference Type BACKGROUND
PMID: 23044644 (View on PubMed)

Jwair S, Boerboom RA, Versnel H, Stokroos RJ, Thomeer HGXM. Evaluating cochlear insertion trauma and hearing preservation after cochlear implantation (CIPRES): a study protocol for a randomized single-blind controlled trial. Trials. 2021 Dec 9;22(1):895. doi: 10.1186/s13063-021-05878-2.

Reference Type BACKGROUND
PMID: 34886884 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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NL8586

Identifier Type: OTHER

Identifier Source: secondary_id

NL71233.041.19

Identifier Type: -

Identifier Source: org_study_id

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