Previous Page  87 / 162 Next Page
Information
Show Menu
Previous Page 87 / 162 Next Page
Page Background

85

4

may produce a truly asymmetric excitation of nerve fibers. Such real asymmetric spreading of excitation is,

however, enhanced by limitations of the recording methodology.

The use of tonotopy is one of the key contributing factors to the speech perception potential of multichannel

cochlear implants. Theoretically, a well controlled, limited SOE would allow for more independent

information channels, which could ultimately lead to better speech understanding. Unfortunately, like

other studies (Hughes & Abbas, 2006a; Hughes & Stille, 2008) we were not able to demonstrate any

significant correlation between SOE and speech perception. In this perspective it is worthwhile to reconcile

the fact that the data in the present study were obtained at high current levels, and that we observed

no inter-level differences in excitation width for normalized data. Nevertheless, the eCAP amplitudes

obtained at these current levels varied by up to a factor of two between the low and the high current levels,

suggesting that the response was not in saturation. However, in some individual cases with low noise levels

and relatively large eCAP amplitudes, a clear decrease in SOE width could be seen with decreasing current

levels. Surprisingly, these findings do not confirm previous research that was able to demonstrate level

effects on SOE in patients, tested at the upper portion of the behavioral dynamic range (Abbas et al, 2004;

Hughes & Stille, 2010). For the subjects of our study measurements at current levels used in daily use may

show narrower SOE curves, but with present hardware limitations (especially system noise levels) it was not

possible to test this hypothesis by measuring at low current levels.

Additionally, the fact that intraoperatively derived eCAP SOE measures are compared with speech

perception measured two years later could account for the lack of correlation. eCAP measures are known to

change over time (Hughes et al, 2000, 2001; Gordon et al, 2004) and SOE measured at the same time as

the speech perception test would have given additional information. Unfortunately, however, it turned out

to be not feasible in our clinical setting to re-assess SOE in the same patient group two years postoperatively.

For the selectivity curves this study showed no significant differences between a roving masker (with fixed

probe) position and roving probe (with fixed masker). This is in agreement with theoretical expectations

as both probe or masker fixed should measure the same overlap between the areas excited by masker and

probe and should therefore give the same response. The advantage of the first condition is that the distance

between recording electrode and probe is constant, stabilizing possible artefacts in the recorded response. On

the other hand, with a roving probe the distance of the probe to the recording contact is larger at locations

remote from the contact of interest (i.e. the masker contact), resulting in a reduced artefact interference. The

conformity in response with probe or masker fixed indicates that SOE curves are relatively robust in relation

to artefacts and other secondary effects.

In contrast to selectivity, scanning allows both forward masking as well as alternating polarity as the artefact

rejection method. The choice of method did not appear to affect the widths of the recorded scanning

curves. The alternating polarity artefact rejection takes slightly less time and is used in clinical practice (with

Advanced Bionics cochlear implants), but has the disadvantage of averaging different latencies produced