Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation
Introduction: The objectives of the current study were to (1) determine the relationship between electrocochleography (ECochG), measured from the cochlear implant (CI) electrode array during and after implantation, and postoperative audiometric thresholds, (2) determine the relationship between ECoc...
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| Format: | Article |
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Frontiers Media S.A.
2017-05-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fnins.2017.00291/full |
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| author | Brendan P. O'Connell Jourdan T. Holder Robert T. Dwyer René H. Gifford René H. Gifford Jack H. Noble Jack H. Noble Marc L. Bennett Alejandro Rivas George B. Wanna David S. Haynes Robert F. Labadie Robert F. Labadie |
| author_facet | Brendan P. O'Connell Jourdan T. Holder Robert T. Dwyer René H. Gifford René H. Gifford Jack H. Noble Jack H. Noble Marc L. Bennett Alejandro Rivas George B. Wanna David S. Haynes Robert F. Labadie Robert F. Labadie |
| author_sort | Brendan P. O'Connell |
| collection | DOAJ |
| description | Introduction: The objectives of the current study were to (1) determine the relationship between electrocochleography (ECochG), measured from the cochlear implant (CI) electrode array during and after implantation, and postoperative audiometric thresholds, (2) determine the relationship between ECochG amplitude and electrode scalar location determined by computerized tomography (CT); and (3) determine whether changes in cochlear microphonic (CM) amplitude during electrode insertion were associated with postoperative hearing.Materials and Methods: Eighteen subjects undergoing CI with an Advanced Bionics Mid-Scala device were prospectively studied. ECochG responses were recorded using the implant coupled to a custom signal recording unit. ECochG amplitude collected intraoperatively concurrent with CI insertion and at activation was compared with audiometric thresholds postoperatively. Sixteen patients also underwent postoperative CT to determine scalar location and the relationship to ECochG measures and residual hearing.Results: Mean low-frequency pure tone average (LFPTA) increased following surgery by an average of 28 dB (range 8–50). Threshold elevation was significantly greater for electrodes with scalar dislocation. No correlation was found between intraoperative ECochG and postoperative behavioral thresholds collapsed across frequency; however, mean differences in thresholds measured by intraoperative ECochG and postoperative audiometry were significantly smaller for electrodes inserted completely within scala tympani (ST) vs. those translocating from ST to scala vestibuli. A significant correlation was observed between postoperative ECochG thresholds and behavioral thresholds obtained at activation.Discussion: Postoperative audiometry currently serves as a marker for intracochlear trauma though thresholds are not obtained until device activation or later. When measured at the same time-point postoperatively, low-frequency ECochG thresholds correlated with behavioral thresholds. Intraoperative ECochG thresholds, however, did not correlate significantly with postoperative behavioral thresholds suggesting that changes in cochlear physiology occur between electrode insertion and activation. ECochG may hold clinical utility providing surgeons with feedback regarding insertion trauma due to scalar translocation, which may be predictive of postoperative hearing preservation.Conclusion: CI insertion trauma is generally not evident until postoperative audiometry when loss of residual hearing is confirmed. ECochG has potential to provide estimates of trauma during insertion as well as reliable information regarding degree of hearing preservation. |
| first_indexed | 2024-12-12T17:52:14Z |
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| language | English |
| last_indexed | 2024-12-12T17:52:14Z |
| publishDate | 2017-05-01 |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-cc37052fe2ca47c1a62e667f1953f3652022-12-22T00:16:47ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2017-05-011110.3389/fnins.2017.00291262213Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing PreservationBrendan P. O'Connell0Jourdan T. Holder1Robert T. Dwyer2René H. Gifford3René H. Gifford4Jack H. Noble5Jack H. Noble6Marc L. Bennett7Alejandro Rivas8George B. Wanna9David S. Haynes10Robert F. Labadie11Robert F. Labadie12Department of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Hearing and Speech Sciences, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Hearing and Speech Sciences, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Hearing and Speech Sciences, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Computer Science and Electrical Engineering, Vanderbilt UniversityNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Otolaryngology, Vanderbilt University Medical CenterNashville, TN, United StatesDepartment of Computer Science and Electrical Engineering, Vanderbilt UniversityNashville, TN, United StatesIntroduction: The objectives of the current study were to (1) determine the relationship between electrocochleography (ECochG), measured from the cochlear implant (CI) electrode array during and after implantation, and postoperative audiometric thresholds, (2) determine the relationship between ECochG amplitude and electrode scalar location determined by computerized tomography (CT); and (3) determine whether changes in cochlear microphonic (CM) amplitude during electrode insertion were associated with postoperative hearing.Materials and Methods: Eighteen subjects undergoing CI with an Advanced Bionics Mid-Scala device were prospectively studied. ECochG responses were recorded using the implant coupled to a custom signal recording unit. ECochG amplitude collected intraoperatively concurrent with CI insertion and at activation was compared with audiometric thresholds postoperatively. Sixteen patients also underwent postoperative CT to determine scalar location and the relationship to ECochG measures and residual hearing.Results: Mean low-frequency pure tone average (LFPTA) increased following surgery by an average of 28 dB (range 8–50). Threshold elevation was significantly greater for electrodes with scalar dislocation. No correlation was found between intraoperative ECochG and postoperative behavioral thresholds collapsed across frequency; however, mean differences in thresholds measured by intraoperative ECochG and postoperative audiometry were significantly smaller for electrodes inserted completely within scala tympani (ST) vs. those translocating from ST to scala vestibuli. A significant correlation was observed between postoperative ECochG thresholds and behavioral thresholds obtained at activation.Discussion: Postoperative audiometry currently serves as a marker for intracochlear trauma though thresholds are not obtained until device activation or later. When measured at the same time-point postoperatively, low-frequency ECochG thresholds correlated with behavioral thresholds. Intraoperative ECochG thresholds, however, did not correlate significantly with postoperative behavioral thresholds suggesting that changes in cochlear physiology occur between electrode insertion and activation. ECochG may hold clinical utility providing surgeons with feedback regarding insertion trauma due to scalar translocation, which may be predictive of postoperative hearing preservation.Conclusion: CI insertion trauma is generally not evident until postoperative audiometry when loss of residual hearing is confirmed. ECochG has potential to provide estimates of trauma during insertion as well as reliable information regarding degree of hearing preservation.http://journal.frontiersin.org/article/10.3389/fnins.2017.00291/fullcochlear implantelectrocochleographyresidual hearingaudiometrycochlear microphonichearing loss |
| spellingShingle | Brendan P. O'Connell Jourdan T. Holder Robert T. Dwyer René H. Gifford René H. Gifford Jack H. Noble Jack H. Noble Marc L. Bennett Alejandro Rivas George B. Wanna David S. Haynes Robert F. Labadie Robert F. Labadie Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation Frontiers in Neuroscience cochlear implant electrocochleography residual hearing audiometry cochlear microphonic hearing loss |
| title | Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation |
| title_full | Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation |
| title_fullStr | Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation |
| title_full_unstemmed | Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation |
| title_short | Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation |
| title_sort | intra and postoperative electrocochleography may be predictive of final electrode position and postoperative hearing preservation |
| topic | cochlear implant electrocochleography residual hearing audiometry cochlear microphonic hearing loss |
| url | http://journal.frontiersin.org/article/10.3389/fnins.2017.00291/full |
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