Monitoring Cochlear Nerve Integrity During Vestibular Schwannoma Microsurgery in Real-Time Using Cochlear Implant Evoked Auditory Brainstem Response and Streaming Neural Response Imaging

2020 ◽  
Vol 41 (2) ◽  
pp. e201-e207
Author(s):  
Neil S. Patel ◽  
Aniket A. Saoji ◽  
Amy P. Olund ◽  
Matthew L. Carlson
Keyword(s):  
Cochlear Implant ◽  
Real Time ◽  
Vestibular Schwannoma ◽  
Auditory Brainstem Response ◽  
Auditory Brainstem ◽  
Neural Response ◽  
Cochlear Nerve ◽  
Brainstem Response

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.

Temporal bone pathology of acoustic neuroma correlating with presence of electrocochleography and absence of auditory brainstem response

1997 ◽  
Vol 111 (10) ◽  
pp. 967-972 ◽  
Author(s):  
Kimitaka Kaga ◽  
Shinichi Iwasaki ◽  
Akira Tamura ◽  
Jun-Ichi Suzuki ◽  
Hideyuki Haebara
Keyword(s):  
Temporal Bone ◽  
Vestibular Schwannoma ◽  
Auditory Brainstem Response ◽  
Action Potentials ◽  
Auditory Brainstem ◽  
Cochlear Nerve ◽  
Bone Pathology ◽  
Compound Action Potentials ◽  
Brainstem Response ◽  
Compound Action

AbstractThe temporal bone pathology of a 74-year-old female affected by vestibular schwannoma was compared with findings of auditory brainstem response and electrocochleography. At age 71, she complained of hearing loss in the left ear in which pure tone audiometry revealed threshold elevation in the middle- and high-frequency range. Temporal bone CT scanning revealed a medium-sized cerebellopontine angle tumour in the left ear. ABR showed no response in the left ear, but the electrocochleography showed clear compound action potentials. Three years later, at age 74, she died of metastatic lung cancer and sepsis. The left temporal bone pathology consisted primarily of a large vestibular schwannoma occupying the internal auditory meatus. The organ of Corti was well preserved in each turn. In the modiolus, the numbers of spiral ganglion cells and cochlear nerve fibres in each turn were decreased. These histological findings suggest that clear compound action potentials were recorded from the distal portion of the cochlear nerve in spite of the presence of the vestibular schwannoma, but ABR could not be detected because of the blockade of the proximal portion of the cochlear nerve by the vestibular schwannoma.

Comparison of Electrically Evoked Whole-Nerve Action Potential and Electrically Evoked Auditory Brainstem Response Thresholds in Nucleus CI24R Cochlear Implant Recipients

2002 ◽  
Vol 13 (08) ◽  
pp. 416-427 ◽  
Author(s):  
Marcia J. Hay-McCutcheon ◽  
Carolyn J. Brown ◽  
Kelly Schmidt Clay ◽  
Keely Seyle
Keyword(s):  
Action Potential ◽  
Cochlear Implant ◽  
Auditory Brainstem Response ◽  
Electrode Array ◽  
Auditory Brainstem ◽  
Electrode Arrays ◽  
Direct Stimulation ◽  
Nerve Action ◽  
Brainstem Response ◽  
Response Thresholds

In this study, differences between electrically evoked whole-nerve action potential (EAP) and electrically evoked auditory brainstem response (EABR) measurements within Nucleus CI24R cochlear implant recipients were evaluated. Precurved modiolus-hugging internal electrode arrays, such as the CI24R, are designed to provide more direct stimulation of neural elements of the modiolus. If the electrode array is closer to the modiolus, electrically evoked and behavioral levels might be lower than were previously recorded for the straight electrode array, the CI24M. EAP and EABR growth functions and behavioral levels were obtained for 10 postlingually deafened adults. Results revealed no significant differences between EAP and EABR threshold levels, and these levels were not significantly lower than those obtained using the CI24M.

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