Intracochlear Electrocochleography: Influence of Scalar Position of the Cochlear Implant Electrode on Postinsertion Results. Otol Neurotol 2019 Jun;40(5):e503-e510
Date
05/15/2019Pubmed ID
31083085Pubmed Central ID
PMC6530483DOI
10.1097/MAO.0000000000002202Scopus ID
2-s2.0-85066060645 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
HYPOTHESIS: Electrocochleography (ECochG) recorded during cochlear implant (CI) insertion from the apical electrode in conjunction with postinsertion ECochG can identify electrophysiologic differences that exist between groups with and without a translocation of the array from the scala tympani (ST) into the scala vestibuli (SV).
BACKGROUND: Translocation of the CI electrode from ST into SV can limit performance postoperatively. ECochG markers of trauma may be able to aid in the ability to detect electrode array-induced trauma/scalar translocation intraoperatively.
METHODS: Twenty-one adult CI patients were included. Subjects were postoperatively parsed into two groups based on analysis of postoperative imaging: 1) ST (n = 14) insertion; 2) SV (n = 7) insertion, indicating translocation of the electrode. The ECochG response elicited from a 500 Hz acoustic stimulus was recorded from the lead electrode during insertion when the distal electrode marker was at the round window, and was compared to the response recorded from a basal electrode (e13) after complete insertion.
RESULTS: No statistically significant change in mean ECochG magnitude was found in either group between recording intervals. There was a mean loss of preoperative pure-tone average of 52% for the nontranslocation group and 94% for the translocation group.
CONCLUSIONS: Intraoperative intracochlear ECochG through the CI array provides a unique opportunity to explore the impact of the CI electrode on the inner ear. Specifically, a translocation of the array from ST to SV does not seem to change the biomechanics of the cochlear region that lies basal to the area of translocation in the acute period.
Author List
Riggs WJ, Dwyer RT, Holder JT, Mattingly JK, Ortmann A, Noble JH, Dawant BM, Valenzuela CV, O'Connell BP, Harris MS, Litvak LM, Koka K, Buchman CA, Labadie RF, Adunka OFAuthor
Michael S. Harris MD Associate Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAudiometry, Evoked Response
Audiometry, Pure-Tone
Biomechanical Phenomena
Cochlea
Cochlear Implantation
Cochlear Implants
Electrodes
Humans
Monitoring, Intraoperative
Prospective Studies
Scala Tympani
Scala Vestibuli
Tomography, X-Ray Computed
Treatment Outcome