Stimulation conditions leading to electrical vestibular co-stimulation in cochlear implant users

被引:0
作者
Froehlich, Laura [1 ,2 ]
Plontke, Stefan K. [1 ]
Loeffler, Lea B. [1 ]
Manthey, Antonia [1 ]
Rahne, Torsten [1 ]
机构
[1] Martin Luther Univ Halle Wittenberg, Univ Med Halle Saale, Dept Otorhinolaryngol Head & Neck Surg, Venusberg Campus 1, D-53127 Halle An Der Saale, Germany
[2] Univ Med Ctr Bonn, Dept Otorhinolaryngol Head & Neck Surg, Venusberg Campus 1, D-53127 Bonn, Germany
来源
LARYNGOSCOPE INVESTIGATIVE OTOLARYNGOLOGY | 2024年 / 9卷 / 05期
关键词
cochlear implant; co-stimulation; electrical stimulation; VEMP; vestibular; EVOKED MYOGENIC POTENTIALS; BONE-CONDUCTED STIMULI; CHILDREN;
D O I
10.1002/lio2.70011
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
ObjectivesThe study objective was to investigate the influence of electrical stimulus properties on cervical and ocular vestibular-evoked myogenic potentials to electrical stimulation by cochlear implants (e-cVEMPs, e-oVEMPs).MethodsE-VEMPs were recorded in adult Nucleus cochlear implant (CI) patients using electric pulse trains (4 biphasic pulses at 1000 Hz burst rate). Ground path and stimulation electrodes were varied between monopolar stimulation at basal electrode contact E3 (MP1 + 2 E3), monopolar stimulation at apical electrode contact E20 (MP1 + 2 E20), and bipolar transmodiolar stimulation between E3 and E14 (BP E3-E14). The electric pulse train was further varied to 2 pulses at 1000 Hz, 2 pulses at 500 Hz, and a single pulse, in patients with present e-VEMP responses. VEMPs to bone-conducted vibration (BCV) were recorded as reference in all participants.ResultsMeasurements were conducted in 30 ears of 27 participants (mean age 49.3 years, SD 12.7 years). E-VEMPs were present in 13 ears (43%). 5 of the 13 cases showed e-VEMPs but no BCV evoked VEMPs. Response numbers increased with increasing stimulation levels. The highest response rate of 40% was obtained for MP1 + 2 E3 stimulation. Stimulus variation did not affect response numbers. E-VEMP amplitudes were comparable to BCV-stimulated VEMPs. Latencies were up to 3.1 ms shorter for electric stimulation. Some patients showed e-VEMP thresholds close to or below the electric hearing threshold level.ConclusionThe occurrence of e-VEMPs is dependent on current path and stimulation level. Vestibular co-stimulation by the CI is more likely in patients with high stimulation levels and for monopolar stimulation of basal electrode contacts.Level of Evidence4. The study investigated electrical vestibular co-stimulation by recording of e-cVEMPs and e-oVEMPs to variations of ground path and stimulation electrode as well as modifications of stimulus frequency and number of pulses. The results showed that vestibular co-stimulation occurred in 43% of cases and is more likely in patients with high stimulation levels and for monopolar stimulation of basal electrode contacts. Some patients showed e-VEMP thresholds close to or below the electric hearing threshold level, which implies that vestibular co-stimulation can occur in daily CI use with clinical maps. image
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页数:8
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