- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04651660
Using Electrocochleography During Cochlear Implantation of the Neuro Zti. (PIC-22_eCoN)
Using Electrocochleography to Guide Insertion of the Electrode Array During Cochlear Implantation of the Neuro Zti (eCoN)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Main study procedures and assessments:
- Visit 1 (D-30+/-14) INCLUSION: subject information/consent, inclusion/exclusion criteria, CT-scan, Tonal audiometry
- Visit 2 (D0+/-14) COCHLEAR IMPLANT SURGERY: CT-scan, Intra-op eCochG, eCAP, Impedance
- Visit 3 (D+30+/-14) FOLLOW-UP 1 MONTH: Tonal audiometry, Impedance, Fitting maps
- Visit 4 (D+60+/-14) FOLLOW-UP 2 MONTH: Tonal audiometry, Impedance, Fitting maps, Phonemes
- Visit 5 (D+90+/-14) FOLLOW-UP 3 MONTH: Tonal audiometry, Impedance, Fitting maps, Phonemes
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Sarah SC CHOUIKH
- Phone Number: +33493951818
- Email: saoh@oticonmedical.com
Study Contact Backup
- Name: Michel MH HOEN
- Phone Number: +33493951818
- Email: mhoe@oticonmedical.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- > or equal 18 years ;
- Candidate for Neuro Zti EVO cochlear implant system, unilateral or bilateral recipient ;
- Preoperative residual hearing with audiometric thresholds less or equal than 80 dB at 500 Hz, or higher frequencies
Exclusion Criteria:
- Medical or psychological conditions which contraindicate surgery (e.g middle ear infection, tympanic membrane perforation) ;
- Patient with a psychological or linguistic inability to understand the information sheet ;
- Patient under legal protection or deprived of liberty
- Patient included and participating to another trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Manual Insertion
The surgeon will follow a classical surgical procedure for the cochlear implantation, i.e. mastoidectomy to access the temporal bone, posterior tympanotomy to access the cochlea and round window (RW) approach for the CI electrode array insertion.
Before opening the RW, the eCochG recording electrode is placed on the cochlear promontory, and placed not to obstruct the surgery.
The probe is thus maintained during the whole MANUAL insertion (by the surgeon).
|
Before the mastoidectomy, the ear canal is cleaned, the insert earphone is connected to the Eclipse (Oticon Medical software) preamplifier and placed into the ear canal. The EEG scalp electrodes (active, ground electrode) are placed on the patient's head. After the posterior tympanotomy, the reference electrode (eCochG probe) is placed on the cochlear promontory. The CI electrode array will be inserted following one of the two possible techniques while the eCochG will be recording. The surgeon will either manually insert the array using the Oticon Medical stylet and following the surgery guides and recommendations from Oticon Medical or will control the Robotol insertion angle and drive the robotic arm in the same way. |
Experimental: Robotic insertion
The surgeon will follow a classical surgical procedure for the cochlear implantation, i.e. mastoidectomy to access the temporal bone, posterior tympanotomy to access the cochlea and round window (RW) approach for the CI electrode array insertion.
Before opening the RW, the eCochG recording electrode is placed on the cochlear promontory, and placed not to obstruct the surgery.
The probe is thus maintained during the whole ROBOTIC insertion.
|
Before the mastoidectomy, the ear canal is cleaned, the insert earphone is connected to the Eclipse (Oticon Medical software) preamplifier and placed into the ear canal. The EEG scalp electrodes (active, ground electrode) are placed on the patient's head. After the posterior tympanotomy, the reference electrode (eCochG probe) is placed on the cochlear promontory. The CI electrode array will be inserted following one of the two possible techniques while the eCochG will be recording. The surgeon will either manually insert the array using the Oticon Medical stylet and following the surgery guides and recommendations from Oticon Medical or will control the Robotol insertion angle and drive the robotic arm in the same way. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Correlation coefficient between the eCochG trauma index (in µV) and the residual hearing (in dB HL).
Time Frame: Through study completion, an average of 2 years
|
The eCochG trauma index correspond to electrophysiological changes of the cochlear response during the CI electrode insertion, and is calculated from the difference between post-insertion and pre-insertion eCochG measure (in µV). The hearing loss is calculated from the difference between the post-surgical and pre-surgical hearing thresholds (in dB HL). The correspondence is calculated from the correlation coefficient between the eCochG trauma index and the hearing loss. It is expected that a potential damage measured by the eCochG during the surgery have affected auditory threshold. |
Through study completion, an average of 2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Significant decrease of eCochG trauma index (in µV) for electrode array insertion performed manually compared to robotic.
Time Frame: Through study completion, average of 2 years
|
eCochG trauma index (µV) as a result of manual electrode insertion compared with robotic insertion. Different behaviors of audiological markers since the cochlea may have suffered from biological cell degradation due to the CI electrode insertion. Allied with cochlear degradation will come increased tissue scar density, subsequently increased resistivity of the biological field to the electrical current. This would imply a cascade effect of electrical and audiological outcomes (higher impedances, higher electrical charges required to evoke a sound or the auditory nerve feedback - eCAP, lower overall performances). |
Through study completion, average of 2 years
|
Correlation coefficient between the eCochG trauma index (in µV) and a misplacement of the electrode array inside the cochlea based on CT scan.
Time Frame: Through study completion, average of 2 years
|
The misplacement will be quantified with the cochlear coverage (in %) and a subjective assessment of the Eschraghi trauma index for exploratory purpose. eCochG trauma index (µV) with placement of the CI electrode array in the cochlea (using Pre and Post surgical CT scans). |
Through study completion, average of 2 years
|
Correlation coefficient between the eCochG trauma index (in nV) with the electrical charges (in nC) required to elicit eCAP threshold.
Time Frame: Through study completion, average of 2 years
|
eCochG trauma index (µV) with eCAP thresholds (nC).
|
Through study completion, average of 2 years
|
Correlation coefficient between the eCochG trauma index (in nV) with impedance measurement (in Ω).
Time Frame: Through study completion, average of 2 years
|
eCochG trauma index (µV) with CI electrode impedances (Ohm).
|
Through study completion, average of 2 years
|
Correlation coefficient between the eCochG trauma index (in nV) with fitting map electrical charges (in nC), and slopes of their growth functions.
Time Frame: Through study completion, average of 2 years
|
eCochG trauma index (µV) with electrical charge (nC) measured on the patient CI fitting map.
|
Through study completion, average of 2 years
|
Correlation coefficient between the eCochG trauma index (in nV) with scores of phonemes discrimination (%).
Time Frame: Through study completion, average of 2 years
|
eCochG trauma index (µV) with scores (in %) of phonemes recognition.
|
Through study completion, average of 2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Yann YN Nguyen, Hôpital Pitié-Salpêtrière (Paris)
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PIC-22
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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