Usefulness of Electrical Auditory Brainstem Responses to Assess the Functionality of the Cochlear Nerve Using an Intracochlear Test Electrode

2017 ◽  
Vol 38 (10) ◽  
pp. e413-e420 ◽  
Author(s):  
Luis Lassaletta ◽  
Marek Polak ◽  
Jan Huesers ◽  
Miguel Díaz-Gómez ◽  
Miryam Calvino ◽  
...  
Keyword(s):  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Test Electrode

scholarly journals Intraoperative Monitoring of the Cochlear Nerve during Neurofibromatosis Type-2 Vestibular Schwannoma Surgery and Description of a “Test Intracochlear Electrode”

2019 ◽  
Vol 80 (01) ◽  
pp. e1-e9 ◽  
Author(s):  
Anand Kasbekar ◽  
Yu Chuen Tam ◽  
Robert Carlyon ◽  
John Deeks ◽  
Neil Donnelly ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Vestibular Schwannoma ◽  
Intraoperative Monitoring ◽  
Neurofibromatosis Type ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Tertiary Referral Center ◽  
Objective Evidence ◽  
Brainstem Response

Objectives A decision on whether to insert a cochlear implant can be made in neurofibromatosis 2 (NF2) if there is objective evidence of cochlear nerve (CN) function post vestibular schwannoma (VS) excision. We aimed to develop intraoperative CN monitoring to help in this decision. Design We describe the intraoperative monitoring of a patient with NF2 and our stimulating and recording set up. A novel test electrode is used to stimulate the CN electrically. Setting This study was set at a tertiary referral center for skull base pathology. Main outcome measure Preserved auditory brainstem responses leading to cochlear implantation. Results Electrical auditory brainstem response (EABR) waveforms will be displayed from different stages of the operation. A cochlear implant was inserted at the same sitting based on the EABR. Conclusion Electrically evoked CN monitoring can provide objective evidence of CN function after VS excision and aid in the decision-making process of hearing rehabilitation in patients who will be rendered deaf.

Selective cochlear neurotomy in the cerebellopontine cistern using electrophysiological monitoring in a patient with intractable tinnitus

1997 ◽  
Vol 86 (6) ◽  
pp. 1053-1056 ◽  
Author(s):  
Hiroshi Ryu ◽  
Seiji Yamamoto ◽  
Kenji Sugiyama ◽  
Kenichi Uemura
Keyword(s):  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Content Type ◽  
Compound Action Potentials ◽  
Choice Of Treatment ◽  
Safe Technique ◽  
Severe Tinnitus ◽  
Compound Action

✓ Selective cochlear neurotomy for intractable tinnitus is quite difficult to perform because there is no way to approach the cochlear nerve without interfering with other neural structures. The authors successfully performed selective cochlear neurotomy in the cerebellopontine cistern in a patient with persistent intractable high-pitched tinnitus, but with normal hearing and vestibular functions, by monitoring cochlear nerve compound action potentials and auditory brainstem responses. The procedure is a very simple and safe technique for the treatment of intractable tinnitus. Although this destructive procedure is the last choice of treatment, it can be justified in patients who have poor hearing and severe tinnitus in spite of normal vestibular functions. The procedure may also be applied in some rare cases such as that of the present patient whose quality of life was markedly reduced because loud tinnitis prevented him from hearing anything with the affected ear even though his hearing and vestibular functions were normal.

Transient facial nerve palsy after topical papaverine application during vestibular schwannoma surgery

2007 ◽  
Vol 107 (5) ◽  
pp. 1039-1042 ◽  
Author(s):  
James K. Liu ◽  
Christina M. Sayama ◽  
Clough Shelton ◽  
Joel D. MacDonald
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Conduction Block ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Speech Discrimination ◽  
The Right

✓Some evidence in the literature supports the topical application of papaverine to the cochlear nerve to prevent internal auditory artery vasospasm and cochlear ischemia as a method of enhancing the ability to preserve hearing during acoustic neuroma surgery. The authors report a case of transient facial nerve palsy that occurred after papaverine was topically applied during a hearing preservation acoustic neuroma removal. A 58-year-old woman presented with tinnitus and serviceable sensorineural hearing loss in her right ear (speech reception threshold 15 dB, speech discrimination score 100%). Magnetic resonance imaging demonstrated a 1.5-cm acoustic neuroma in the right cerebellopontine angle (CPA). A retrosigmoid approach was performed to achieve gross-total resection of the tumor. During tumor removal, a solution of 3% papaverine soaked in a Gelfoam pledget was placed over the cochlear nerve. Shortly thereafter, the quality of the facial nerve stimulation deteriorated markedly. Electrical stimulation of the facial nerve did not elicit a response at the level of the brainstem but was observed to elicit a robust response more peripherally. There were no changes in auditory brainstem responses. Immediately after surgery, the patient had a House–Brackmann Grade V facial palsy on the right side. After several hours, this improved to a Grade I. At the 1-month follow-up examination, the patient exhibited normal facial nerve function and stable hearing. Intracisternal papaverine may cause a transient facial nerve palsy by producing a temporary conduction block of the facial nerve. This adverse effect should be recognized when topical papaverine is used during CPA surgery.

Auditory Brainstem Implant (ABI): New Frontiers in Adults and Children

2005 ◽  
Vol 133 (1) ◽  
pp. 126-138 ◽  
Author(s):  
Vittorio Colletti ◽  
Marco Carner ◽  
Veronica Miorelli ◽  
Maurizio Guida ◽  
Liliana Colletti ◽  
...  
Keyword(s):  
Electrode Array ◽  
Neurofibromatosis Type ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Closed Set ◽  
Sentence Recognition ◽  
Auditory Brainstem Implant ◽  
Open Set ◽  
Cochlear Nerve Aplasia

Previous studies have considered only patients with neurofibromatosis type 2 (NF2) older than 12 years as candidates for an auditory brainstem implant (ABI). Our study expands the potential criteria to include both children and adult subjects with other cochlear or cochlear nerve malfunctions who either would not benefit at all from a cochlear implant (eg, cochlear nerve aplasia or avulsion) or whose benefit was or would be severely compromised (eg, cochlear ossification, cochlear fracture). STUDY DESIGN: In our department, over the period from April 1997 to September 2002, 29 patients, 20 adults and 9 children, were fitted with ABIs. Their ages ranged from 14 months to 70 years. Thirteen subjects had tumors, 10 NF2 and 3 solitary vestibular schwannoma, and 16 patients had a variety of nontumor (NT) cochlear or cochlear nerve diseases. A retrosigmoid-transmeatal approach was used in T and a retrosigmoid approach in NT patients. The electrode array was inserted into the lateral recess of the fourth ventricle and correct electrode positioning was monitored with the aid of electrically evoked auditory brainstem responses (EABRs). RESULTS: Correct implantation was achieved in all patients. No complications were observed due to implantation surgery or related to ABI activation or long-term use. Auditory sensations were induced in all patients with various numbers of electrodes (from 5 to 15). Different pitch sensations were identifiable with different electrode stimulation. Closed-set word recognition, open-set sentence recognition, and speech tracking scores achieved by the patients are reported in detail. The auditory performance of the patients showed significantly better outcomes than controls (Multicentric European clinical investigations on ABI with NF2). CONCLUSION: We have shown that the indications for the ABI can be extended to include NT patients with severe cochlear and/or cochlear nerve abnormalities. The degree of auditory benefit varies as a function of the underlying pathological conditions, with NT subjects exhibiting significantly better outcomes than the T patients.

scholarly journals Unilateral Auditory Neuropathy Caused by Cochlear Nerve Deficiency

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Cheng Liu ◽  
Xingkuan Bu ◽  
Feiyun Wu ◽  
Guangqian Xing
Keyword(s):  
Otoacoustic Emissions ◽  
Internal Auditory Canal ◽  
Auditory Brainstem ◽  
Auditory Neuropathy ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Maximum Output ◽  
Neural Responses ◽  
Ear Effusion ◽  
Cochlear Nerve Deficiency

Objective. To explore possible corelationship between the cochlear nerve deficiency (CND) and unilateral auditory neuropathy (AN).Methods. From a database of 85 patients with unilateral profound sensorineural hearing loss, eight who presented with evoked otoacoustic emissions (EOAEs) or cochlear microphonic (CM) in the affected ear were diagnosed with unilateral AN. Audiological and radiological records in eight patients with unilateral AN were retrospectively reviewed.Results. Eight cases were diagnosed as having unilateral AN caused by CND. Seven had type “A” tympanogram with normal EOAE in both ears. The other patient had unilateral type “B” tympanogram and absent OAE but CM recorded, consistent with middle ear effusion in the affected ear. For all the ears involved in the study, auditory brainstem responses (ABRs) were either absent or responded to the maximum output and the neural responses from the cochlea were not revealed when viewed by means of the oblique sagittal MRI on the internal auditory canal.Conclusion. Cochlear nerve deficiency can be seen by electrophysiological evidence and may be a significant cause of unilateral AN. Inclined sagittal MRI of the internal auditory canal is recommended for the diagnosis of this disorder.

scholarly journals Peran implanted electrically evoked auditory brainstem responses(Imp-eABR) pada pasien tuli kongenital

2019 ◽  
Vol 49 (20) ◽  
Author(s):  
Fikri Mirza Putranto ◽  
Jenny Bashiruddin ◽  
Semiramis Zizlavsky ◽  
Irawan Mangunatmadja ◽  
Jacub Pandelaki ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Auditory Pathway ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Auditory Brainstem Responses ◽  
Auditory Pathways ◽  
Internal Factors ◽  
Brainstem Response

Latar belakang: Variasi performa pasca implan koklea menunjukkan adanya variasi patologi yang belum dapat dijelaskan melalui pemeriksaan standar pra-operasi. Untuk itu dibutuhkan pemeriksaan yang dapat menunjukkan variasi integritas jaras auditori sebagai petunjuk variasi potensi internal tiap individu. Tujuan: Mendapatkan variasi respons jaras auditori terhadap stimulus listrik pasca implan berdasarkan pemeriksaan Implanted Electrically evoked Auditory Brainstem Respons (Imp-eABR), serta korelasinya dengan faktor internal pra-implan lain berupa usia, luas area n. koklearis dan kemampuan komunikasi pra-operasi. Metode: Kriteria subjek penelitian adalah pasien operasi implan koklea berusia kurang dari 10 tahun, memiliki koklea dan n. koklearis normal, dan pada pasien berusia lebih dari 4 tahun sudah memakai alat bantu dengar minimal 1 tahun. Pemeriksaan Imp-eABR dilakukan terhadap 5 elektrode yang mewakili area apikal, medial dan basal koklea. Dicari hubungan respons dari stimulasi terhadap ketiga faktor internal.Hasil:Pemeriksaan Imp-eABR dilakukan terhadap 28 telinga dari 19 pasien yang dilakukan operasi secara unilateral dan bilateral. Rerata skor total respons Imp-eABR adalah 6,3 + 2,63; dengan 60,7% telinga memiliki skor total kurang dari 8. Uji regresi linear menunjukkan faktor usia, luas area n. koklearis dan kemampuan komunikasi berkorelasi secara bermakna dan dapat memprediksi variasi skor Imp-eABR sebanyak 49,2%. Kesimpulan:Variasi skor total Imp-eABR pada pasien dengan faktor internal pra-operasi menunjukkan adanya patogenesis lain yang mendasari kemampuan transmisi jaras pendengaran retrokoklea terhadap stimulasi listrik dari implan koklea. Faktor internal pra-operasi dapat menjelaskan kurang dari 50% variasi respons Imp-eABR. Kata kunci: Imp-eABR, luas area n. koklearis, implant koklea, integritas jaras auditori ABSTRACT Background:Variations in performance after cochlear implant indicates pathology variations that cannot be explained through standard preoperative examination. Therefore, an examination is needed to show variations in the integrity of auditory pathways as a guide to internal potential variations of each individual. Objectives: To show variations of auditory pathways responses to electrical stimulation from cochlear implant by performing Implanted Electrically evoked Auditory Brainstem Response (Imp-eABR) examination and to find its correlation to age, cochlear nerve area and preoperative communication skills. Methods: Subjects were cochlear implant patients with age less than 10 years, had normal cochlear and cochlear nerve,and patients over 4 years old with history of wearing hearing aids for at least 1 year. The Imp-eABR examination was performed to 5 electrodes representing the apical, medial and basal areas of the cochlea. Results:Imp-eABR examination was performed on 28 ears from 19 patients who underwent unilateral and bilateral surgery. The average total score of Imp-eABR responses was 6.3 + 2.63; with 60.7% of the ears having a total score of less than 8. Linear regression tests showed age,cochlear nerve area,andcommunicationabilitysignificantlycorrelate,it canexplain49.2%ofthevariationinthetotal Imp-eABR score. Conclusion: The variation in the total Imp-eABR score in patients with preoperative internal factors indicated that another pathogenesis also underlines the ability of transmission of the retrocochlear auditory pathway to electrical stimulation from the cochlear implant. Preoperative internal factors can only explain less than 50% of the variation of the Imp-eABR response.   

The Effect of Kalman-Weighted Averaging and Artifact Rejection on Residual Noise During Auditory Brainstem Response Testing

2019 ◽  
Vol 28 (1) ◽  
pp. 114-124
Author(s):  
Linda W. Norrix ◽  
Julie Thein ◽  
David Velenovsky
Keyword(s):  
Repeated Measures ◽  
Auditory Brainstem ◽  
Weighted Averaging ◽  
Auditory Brainstem Responses ◽  
Residual Noise ◽  
Electrophysiological Recordings ◽  
Artifact Rejection ◽  
Brainstem Response ◽  
Active Motor ◽  
Averaging Time

Purpose Low residual noise (RN) levels are critically important when obtaining electrophysiological recordings of threshold auditory brainstem responses. In this study, we examine the effectiveness and efficiency of Kalman-weighted averaging (KWA) implemented on the Vivosonic Integrity System and artifact rejection (AR) implemented on the Intelligent Hearing Systems SmartEP system for obtaining low RN levels. Method Sixteen adults participated. Electrophysiological measures were obtained using simultaneous recordings by the Vivosonic and Intelligent Hearing Systems for subjects in 2 relaxed conditions and 4 active motor conditions. Three averaging times were used for the relaxed states (1, 1.5, and 3 min) and for the active states (1.5, 3, and 6 min). Repeated-measures analyses of variance were used to examine RN levels as a function of noise reduction strategy (i.e., KWA, AR) and averaging time. Results Lower RN levels were obtained using KWA than AR in both the relaxed and active motor states. Thus, KWA was more effective than was AR under the conditions examined in this study. Using KWA, approximately 3 min of averaging was needed in the relaxed condition to obtain an average RN level of 0.025 μV. In contrast, in the active motor conditions, approximately 6 min of averaging was required using KWA. Mean RN levels of 0.025 μV were not attained using AR. Conclusions When patients are not physiologically quiet, low RN levels are more likely to be obtained and more efficiently obtained using KWA than AR. However, even when using KWA, in active motor states, 6 min of averaging or more may be required to obtain threshold responses. Averaging time needed and whether a low RN level can be attained will depend on the level of motor activity exhibited by the patient.

Effects of Aging on the Subcortical Encoding of Stop Consonants

2020 ◽  
Vol 29 (3) ◽  
pp. 391-403
Author(s):  
Dania Rishiq ◽  
Ashley Harkrider ◽  
Cary Springer ◽  
Mark Hedrick
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Mixed Model ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
Aging Effects ◽  
Formant Frequency ◽  
Place Of Articulation ◽  
Second Formant ◽  
Effects Of Aging

Purpose The main purpose of this study was to evaluate aging effects on the predominantly subcortical (brainstem) encoding of the second-formant frequency transition, an essential acoustic cue for perceiving place of articulation. Method Synthetic consonant–vowel syllables varying in second-formant onset frequency (i.e., /ba/, /da/, and /ga/ stimuli) were used to elicit speech-evoked auditory brainstem responses (speech-ABRs) in 16 young adults ( M age = 21 years) and 11 older adults ( M age = 59 years). Repeated-measures mixed-model analyses of variance were performed on the latencies and amplitudes of the speech-ABR peaks. Fixed factors were phoneme (repeated measures on three levels: /b/ vs. /d/ vs. /g/) and age (two levels: young vs. older). Results Speech-ABR differences were observed between the two groups (young vs. older adults). Specifically, older listeners showed generalized amplitude reductions for onset and major peaks. Significant Phoneme × Group interactions were not observed. Conclusions Results showed aging effects in speech-ABR amplitudes that may reflect diminished subcortical encoding of consonants in older listeners. These aging effects were not phoneme dependent as observed using the statistical methods of this study.

Comparisons of Auditory Brainstem Responses Between a Laboratory and Simulated Home Environment

2020 ◽  
Vol 63 (11) ◽  
pp. 3877-3892
Author(s):  
Ashley Parker ◽  
Candace Slack ◽  
Erika Skoe
Keyword(s):  
Home Environment ◽  
Signal To Noise Ratio ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
Single Family ◽  
Adult Participants ◽  
Simulated Home Environment ◽  
Brainstem Response ◽  
Research Populations ◽  
Response Consistency

Purpose Miniaturization of digital technologies has created new opportunities for remote health care and neuroscientific fieldwork. The current study assesses comparisons between in-home auditory brainstem response (ABR) recordings and recordings obtained in a traditional lab setting. Method Click-evoked and speech-evoked ABRs were recorded in 12 normal-hearing, young adult participants over three test sessions in (a) a shielded sound booth within a research lab, (b) a simulated home environment, and (c) the research lab once more. The same single-family house was used for all home testing. Results Analyses of ABR latencies, a common clinical metric, showed high repeatability between the home and lab environments across both the click-evoked and speech-evoked ABRs. Like ABR latencies, response consistency and signal-to-noise ratio (SNR) were robust both in the lab and in the home and did not show significant differences between locations, although variability between the home and lab was higher than latencies, with two participants influencing this lower repeatability between locations. Response consistency and SNR also patterned together, with a trend for higher SNRs to pair with more consistent responses in both the home and lab environments. Conclusions Our findings demonstrate the feasibility of obtaining high-quality ABR recordings within a simulated home environment that closely approximate those recorded in a more traditional recording environment. This line of work may open doors to greater accessibility to underserved clinical and research populations.

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