Electrocochleography during Cochlear Implantation for Hearing Preservation

被引:63
作者
Mandala, Marco [1 ]
Colletti, Liliana [1 ]
Tonoli, Giovanni [1 ]
Colletti, Vittorio [1 ]
机构
[1] Univ Verona, ENT Dept, I-37134 Verona, Italy
关键词
intraoperative; monitoring; electrocochleography; cochlear implant; hearing preservation; RESIDUAL HEARING; ELECTRODE PLACEMENT;
D O I
10.1177/0194599811435895
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective. To determine whether intraoperative electrocochleography during cochlear implant surgery provides online feedback to modify surgical procedure, reduce trauma, and increase preservation of residual hearing. Study Design. Prospective cohort study. Setting. Tertiary referral center, Otolaryngology Department, University of Verona. Subjects and Methods. Twenty-seven adult patients undergoing cochlear implant surgery who had low- to mid-frequency (0.25-2 kHz) auditory thresholds measured preoperatively were enrolled. Fifteen subjects had compound action potentials measured to assess cochlear function during surgery. In those patients, surgery was modified according to electrocochleographic feedback. Twelve control subjects underwent cochlear implant surgery with blinded electrocochleographic monitoring. Results. The average preoperative pure-tone audiometry thresholds (0.25-2 kHz) were 74.3 +/- 10.2 and 81.5 +/- 12.7 dB hearing level (HL) in the electrocochleographic feedback and control cohorts, respectively (P > .05). Compound action potential recordings showed a mean maximum latency shift of 0.63 +/- 0.36 ms and normalized amplitude deterioration of 59% +/- 19% during surgery. All of these changes reverted to normal after electrode insertion in all but 1 subject in the electrocochleographic feedback group. The average shifts in postoperative pure-tone average threshold (0.25-2 kHz), evaluated before activation, were 8.7 +/- 4.3 and 19.2 +/- 11.4 dB HL in the electrocochleographic feedback and control cohorts, respectively (P = .0051). Complete hearing preservation (loss of <= 10 dB) at 1 month before activation was achieved in 85% (11/13) of electrocochleographic feedback subjects and in 33% (4/12) of control patients (P = .0154). Conclusion. Monitoring cochlear function with electrocochleography gives real-time feedback during surgery, providing objective data that might help in modifying the surgical technique in ways that can improve the rate of hearing preservation.
引用
收藏
页码:774 / 781
页数:8
相关论文
共 20 条
[1]   Combining perimodiolar electrode placement and atraumatic insertion properties in cochlear implantation - fact or fantasy? [J].
Adunka, OF ;
Pillsbury, HC ;
Kiefer, J .
ACTA OTO-LARYNGOLOGICA, 2006, 126 (05) :475-482
[2]   Cochleostomy site: Implications for electrode placement and hearing preservation [J].
Briggs, RJS ;
Tykocinski, M ;
Stidham, K ;
Roberson, JB .
ACTA OTO-LARYNGOLOGICA, 2005, 125 (08) :870-876
[3]  
Briggs Robert J S, 2006, Audiol Neurootol, V11 Suppl 1, P42, DOI 10.1159/000095613
[4]   Residual Hearing Preservation After Pediatric Cochlear Implantation [J].
Brown, Ryan F. ;
Hullar, Timothy E. ;
Cadieux, Jamie H. ;
Chole, Richard A. .
OTOLOGY & NEUROTOLOGY, 2010, 31 (08) :1221-1226
[5]   Correlation of Early Auditory Potentials and Intracochlear Electrode Insertion Properties: An Animal Model Featuring Near Real-Time Monitoring [J].
Campbell, Adam P. ;
Suberman, Thomas A. ;
Buchman, Craig A. ;
Fitzpatrick, Douglas C. ;
Adunka, Oliver F. .
OTOLOGY & NEUROTOLOGY, 2010, 31 (09) :1391-1398
[6]  
Colletti V, 1998, AUDIOLOGY, V37, P27
[7]  
Cone-Wesson Barbara, 2002, J Am Acad Audiol, V13, P173
[8]   LIMITATIONS OF COCHLEAR-MICROPHONIC MEASUREMENTS [J].
DALLOS, P ;
SCHOENY, ZG ;
CHEATHAM, MA .
JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA, 1971, 49 (04) :1144-&
[9]   TRAVEL TIME IN COCHLEA AND ITS DETERMINATION FROM COCHLEAR-MICROPHONIC DATA [J].
DALLOS, P ;
CHEATHAM, MA .
JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA, 1971, 49 (04) :1140-&
[10]   Combining acoustic and electrical hearing [J].
Gantz, BJ ;
Turner, CW .
LARYNGOSCOPE, 2003, 113 (10) :1726-1730