Faculty Collaboration Database

Amplitude Parameters Are Predictive of Hearing Preservation in a Randomized Controlled Trial of Intracochlear Electrocochleography During Cochlear Implant Surgery. Otol Neurotol 2024 Sep 01;45(8):887-894

Date

07/26/2024

Pubmed ID

39052893

DOI

10.1097/MAO.0000000000004286

Scopus ID

2-s2.0-85199673294 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

OBJECTIVE: To prospectively evaluate the association between hearing preservation after cochlear implantation (CI) and intracochlear electrocochleography (ECochG) amplitude parameters.

STUDY DESIGN: Multi-institutional, prospective randomized clinical trial.

SETTING: Ten high-volume, tertiary care CI centers.

PATIENTS: Adults (n = 87) with sensorineural hearing loss meeting CI criteria (2018-2021) with audiometric thresholds of ≤80 dB HL at 500 Hz.

METHODS: Participants were randomized to CI surgery with or without audible ECochG monitoring. Electrode arrays were inserted to the full-depth marker. Hearing preservation was determined by comparing pre-CI, unaided low-frequency (125-, 250-, and 500-Hz) pure-tone average (LF-PTA) to LF-PTA at CI activation. Three ECochG amplitude parameters were analyzed: 1) insertion track patterns, 2) magnitude of ECochG amplitude change, and 3) total number of ECochG amplitude drops.

RESULTS: The Type CC insertion track pattern, representing corrected drops in ECochG amplitude, was seen in 76% of cases with ECochG "on," compared with 24% of cases with ECochG "off" ( p = 0.003). The magnitude of ECochG signal drop was significantly correlated with the amount of LF-PTA change pre-CI and post-CI ( p < 0.05). The mean number of amplitude drops during electrode insertion was significantly correlated with change in LF-PTA at activation and 3 months post-CI ( p ≤ 0.01).

CONCLUSIONS: ECochG amplitude parameters during CI surgery have important prognostic utility. Higher incidence of Type CC in ECochG "on" suggests that monitoring may be useful for surgeons in order to recover the ECochG signal and preventing potentially traumatic electrode-cochlear interactions.

Author List

Harris MS, Koka K, Thompson-Harvey A, Harvey E, Riggs WJ, Saleh S, Holder JT, Dwyer RT, Prentiss SM, Lefler SM, Kozlowski K, Hiss MM, Ortmann AJ, Nelson-Bakkum ER, Büchner A, Salcher R, Harvey SA, Hoffer ME, Bohorquez JE, Alzhrani F, Alshihri R, Almuhawas F, Danner CJ, Friedland DR, Seidman MD, Lenarz T, Telischi FF, Labadie RF, Buchman CA, Adunka OF

Authors

Michael S. Harris MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin
Kristin Kozlowski AuD Audiologist in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Audiometry, Evoked Response
Audiometry, Pure-Tone
Cochlea
Cochlear Implantation
Cochlear Implants
Female
Hearing
Hearing Loss, Sensorineural
Humans
Male
Middle Aged
Prospective Studies