Abstract
BACKGROUND: This study examined electrical bioimpedance as a biomarker for intracochlear tissue changes after cochlear implant surgery, comparing monopolar, three-point, and four-point impedance measurements over time and evaluating different measurement systems and approaches. METHODS: Impedance measurements were obtained from 21 participants during surgery and at four postoperative stages. Monopolar impedances were recorded using the Bionic Ear Data Collection System (BEDCS) and the Active Insertion Monitoring (AIM) system. Three- and four-point impedances were recorded directly using BEDCS, and indirect three-point impedances were additionally derived from Electrical Field Imaging matrices recorded using BEDCS or AIM. RESULTS: There was an 11% relative error between monopolar measurements from BEDCS and AIM and a 25% discrepancy between direct and indirect three-point measurements. Despite this, direct and indirect measurements from both systems were useful for tracking postoperative impedance shifts. Three- and four-point measurements showed a strong relationship both during and after surgery. Our results suggest that three- and four-point measurements are more specific than monopolar impedances in capturing localized tissue changes. CONCLUSIONS: Three- and four-point impedance measurements are potential markers of intracochlear tissue changes over time. While direct three-point impedance measurements offer higher accuracy, indirect measurements provide a feasible alternative for monitoring intracochlear changes in clinical settings lacking the option of direct measurements.