- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02466763
Prospective Study of Round Window Versus Cochleostomy Approach to CI Surgery
Prospective Randomized Controlled Double-blinded Study Comparing Cochlear Implantation Through a Round Window Versus Cochleostomy Approach
Study Overview
Detailed Description
Cochlear implant procedure has become the standard of care for patients with severe-to-profound sensorineural hearing loss. Successful outcomes are dependent on extrinsic and intrinsic factors. Significant predictive factors for hearing outcomes in patients with CIs have been previously reported. These include, but are not limited to, duration of deafness, level of preimplant speech recognition, pre/postlingual status, and the coupling of device electrodes. Recipient age does not appear to have a significant impact on hearing outcomes in elderly candidates.
A number of recent studies have proposed that intraoperative factors may be important determinants of electrode location and possibly of audiological outcome. Preliminary reports suggest that intracochlear electrode position- specifically, placement within the ST-is associated with improved audiological outcomes. Additionally, different surgical techniques have been proposed to minimize trauma during electrode insertion and to increase the likelihood of placement within the ST - namely round window and anteroinferior cochleostomy electrode insertion.
Currently, the best surgical approach for electrode insertion is highly debated, fueled by a lack of strong evidence to support one method over another. While a number of CI centers have begun to utilize a round window approach, many large volume centers in the United States and world wide continue to routinely employ cochleostomy electrode insertions. With an increasing number of patients being implanted with greater degrees of residual hearing, such data will become critical towards reducing intracochlear injury and optimizing patient outcomes. To the investigators' knowledge, no clinical study has prospectively investigated the relationship between surgical insertion technique, intracochlear electrode location, and postoperative hearing outcomes. To this end, the investigators are initiating a multicenter prospective randomized controlled double-blinded study comparing round window and cochleostomy cochlear implant electrode insertion.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria are:
- 18 years of age or older,
- less than a 10-year duration of deafness in the ear to be implanted,
- primary surgery,
- normal shaped cochleae,
- no retrocochlear pathology, and
- grossly normal cognitive function.
Exclusion criteria are:
- less than 18 years of age,
- prelingual deafness, or
- greater than 10-years duration of deafness in the ear to be implanted;
- prior otologic surgery in the implanted ear (excluding tympanostomy tube placement),
- inner ear malformation present in the ear to be implanted,
- retrocochlear pathology present in the auditory system to be implanted,
- developmental delay or known cognitive impairment, or
- pregnancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: round window
Half of the participants will be randomized to the round window technique of cochlear implant device electrode insertion.
Intervention for participants randomized to the round window arm include having the round window technique used for the electrode insertion during the participant's cochlear implant surgery.
Participants in this arm of the study will also have a post operative CT scan at about three months after surgery.
|
Surgical placement of a cochlear implant device.
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Active Comparator: cochleostomy
Half of the participants will be randomized to the cochleostomy technique of cochlear implant device electrode insertion.
For the participants randomized to the cochleostomy arm, the surgeon will use a cochleostomy technique for the electrode insertion during the participant's cochlear implant surgery.
Participants in this arm of the study will also have a post operative CT scan at about three months after surgery.
|
Surgical placement of a cochlear implant device.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cochlear implant electrode location after surgery
Time Frame: about three months post op
|
a standard temporal bone CT scan will be used to show the location of the electrode in the cochlea
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about three months post op
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Participant levels of speech perception
Time Frame: Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
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standard audiometry speech perception tests will be administered
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Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
|
Participant levels of word recognition scores
Time Frame: Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
|
standard audiometry CNC word score test will be administered
|
Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
|
Participant levels of sentence recognition scores
Time Frame: Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
|
standard audiometry AZBio sentence score test will be administered
|
Preoperatively, and at approximately 1 month, 3 months, 6 months, and 12 months postoperatively
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Matthew Carlson, MD, Mayo Clinic
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 15-000576
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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