App-based daily self-measurement of impedance in cochlear implant users
IntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments,...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/full |
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| author | Sarah Vormelcher Sarah Vormelcher Cornelia Batsoulis Daniel Kley Michael Mair Andreas Büchner |
| author_facet | Sarah Vormelcher Sarah Vormelcher Cornelia Batsoulis Daniel Kley Michael Mair Andreas Büchner |
| author_sort | Sarah Vormelcher |
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| description | IntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments, offering limited temporal resolution of impedance changes. This study aimed to address this gap by implementing daily impedance monitoring using a smartphone app.MethodsA prospective study evaluated the usability of a research app for remote impedance measurements over 4 months following standard CI surgery with a MED-EL FLEX28 electrode. Impedance was recorded twice daily (morning and evening). The mean impedance across all electrode channels was analyzed for four postoperative time periods: early postoperative (up to day 10 postoperatively), late postoperative (from day 11 to ~4 weeks), intensive fitting (from ~4 weeks postoperatively to ~7 weeks) and regular hearing phase (from ~7 weeks to 4 months). Two CI fitting approaches were compared: activation during the early postoperative phase (early activation, EA) and activation during the intensive fitting phase (conventional activation, CA). Morning-to-evening differences in impedance (MED) were also examined.ResultsThe app demonstrated an overall usage rate of 66% (n = 28), indicating moderate-to-high adherence. Except for higher evening impedance values with CA in the late postoperative phase, no significant differences in mean impedance between the fitting approaches were observed (EA: 6.46 kΩ, n = 11; CA: 7.82 kΩ, n = 11; p = 0.04). Significant differences in MED were found during the early postoperative phase (EA: 0.06 kΩ, n = 8; CA: −0.18 kΩ, n = 10; p = 0.04) and the late postoperative phases (EA: 0.85 kΩ, n = 11; CA: 0.03 kΩ, n = 11; p < 0.001).ConclusionRemote impedance measurements via the app can be made over an extended postoperative period. The increased measurement frequency allowed for detailed characterization of impedance dynamics, particularly around the onset of electrical stimulation. No clinically relevant difference in mean impedance was found between EA and CA groups. Daily fluctuations showed consistently lower evening values after stimulation onset. These findings highlight the potential value of this approach for enhancing postoperative CI management. |
| format | Article |
| id | doaj-art-5c45f375afd34e46ae20d255d31ca5a6 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-5c45f375afd34e46ae20d255d31ca5a62025-08-20T03:31:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16180311618031App-based daily self-measurement of impedance in cochlear implant usersSarah Vormelcher0Sarah Vormelcher1Cornelia Batsoulis2Daniel Kley3Michael Mair4Andreas Büchner5Department of Otorhinolaryngology, Hannover Medical School, Hannover, GermanyMED-EL Research Center, MED-EL Medical Electronics GmbH, Hannover, GermanyMED-EL Research Center, MED-EL Medical Electronics GmbH, Hannover, GermanyDepartment of Otorhinolaryngology, Hannover Medical School, Hannover, GermanyMED-EL R&D, MED-EL Medical Electronics GmbH, Innsbruck, AustriaDepartment of Otorhinolaryngology and Cluster of Excellence “Hearing4all”, Hannover Medical School, Hannover, GermanyIntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments, offering limited temporal resolution of impedance changes. This study aimed to address this gap by implementing daily impedance monitoring using a smartphone app.MethodsA prospective study evaluated the usability of a research app for remote impedance measurements over 4 months following standard CI surgery with a MED-EL FLEX28 electrode. Impedance was recorded twice daily (morning and evening). The mean impedance across all electrode channels was analyzed for four postoperative time periods: early postoperative (up to day 10 postoperatively), late postoperative (from day 11 to ~4 weeks), intensive fitting (from ~4 weeks postoperatively to ~7 weeks) and regular hearing phase (from ~7 weeks to 4 months). Two CI fitting approaches were compared: activation during the early postoperative phase (early activation, EA) and activation during the intensive fitting phase (conventional activation, CA). Morning-to-evening differences in impedance (MED) were also examined.ResultsThe app demonstrated an overall usage rate of 66% (n = 28), indicating moderate-to-high adherence. Except for higher evening impedance values with CA in the late postoperative phase, no significant differences in mean impedance between the fitting approaches were observed (EA: 6.46 kΩ, n = 11; CA: 7.82 kΩ, n = 11; p = 0.04). Significant differences in MED were found during the early postoperative phase (EA: 0.06 kΩ, n = 8; CA: −0.18 kΩ, n = 10; p = 0.04) and the late postoperative phases (EA: 0.85 kΩ, n = 11; CA: 0.03 kΩ, n = 11; p < 0.001).ConclusionRemote impedance measurements via the app can be made over an extended postoperative period. The increased measurement frequency allowed for detailed characterization of impedance dynamics, particularly around the onset of electrical stimulation. No clinically relevant difference in mean impedance was found between EA and CA groups. Daily fluctuations showed consistently lower evening values after stimulation onset. These findings highlight the potential value of this approach for enhancing postoperative CI management.https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/fullcochlear implantdaily impedance measurementelectrode impedanceelectrical stimulationremote impedance monitoringimpedance fluctuation |
| spellingShingle | Sarah Vormelcher Sarah Vormelcher Cornelia Batsoulis Daniel Kley Michael Mair Andreas Büchner App-based daily self-measurement of impedance in cochlear implant users Frontiers in Neurology cochlear implant daily impedance measurement electrode impedance electrical stimulation remote impedance monitoring impedance fluctuation |
| title | App-based daily self-measurement of impedance in cochlear implant users |
| title_full | App-based daily self-measurement of impedance in cochlear implant users |
| title_fullStr | App-based daily self-measurement of impedance in cochlear implant users |
| title_full_unstemmed | App-based daily self-measurement of impedance in cochlear implant users |
| title_short | App-based daily self-measurement of impedance in cochlear implant users |
| title_sort | app based daily self measurement of impedance in cochlear implant users |
| topic | cochlear implant daily impedance measurement electrode impedance electrical stimulation remote impedance monitoring impedance fluctuation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/full |
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