To evaluate the efficacy of EMPES [Early implantation, Modiolar Proximity (MP), and Early Switch-on] approach in bilateral cochlear nerve (CN) aplasia.
✦ The floor
Discussion
Signed responses from readers of the wire.
The EMPES protocol (early implantation, modiolar proximity, early switch-on) warrants consideration for bilateral cochlear nerve aplasia candidates, but the retrospective design limits practice-changing conclusions without prospective validation.
Cochlear nerve aplasia is one of the most challenging indications for cochlear implantation; a structured protocol offering even modest outcome gains could reshape candidacy decisions for this rare but severe condition.
- 01Retrospective evaluation of the EMPES protocol in patients with bilateral cochlear nerve aplasia.
- 02Protocol emphasizes three factors: early implantation age, modiolar-hugging electrode placement, and early device activation.
- 03Targets one of the rarest and most complex cochlear implant populations.
- 04Findings are limited by the retrospective, uncontrolled study design.
- 05Results may inform candidacy guidelines and surgical planning for nerve aplasia cases.
The EMPES protocol (early implantation, modiolar proximity, early switch-on) optimizes cochlear implant outcomes in bilateral cochlear nerve aplasia.
studypartially supported- PMID
- 42872457
- DOI
- 10.1097/MAO.0000000000005065.
- Journal
- Otology & Neurotology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients with bilateral cochlear nerve aplasia undergoing cochlear implantation
- Intervention
- EMPES protocol: early cochlear implantation, modiolar-proximate electrode placement, and early device switch-on
Primary outcomes
Cochlear implant audiological outcomes in cochlear nerve aplasia patients