Extra- and Intracochlear Electrocochleography in Cochlear Implant Recipients

Objective: To monitor cochlear function by extra- and intracochlear electrocochleography (ECoG) during and after cochlear implantation and thereby to enhance the understanding of changes in cochlear function following cochlear implantation surgery. Methods: ECoG responses to acoustic stimuli of 250, 500 and 1,000 Hz were recorded in 9 cochlear implant recipients with presurgical residual hearing. During surgery extracochlear ECoG recordings were performed before and after insertion of the cochlear implant electrode array. After insertion of the electrode array, intracochlear ECoG recordings were conducted using intracochlear electrode contacts as recording electrodes. Intracochlear ECoG recordings were performed up to 6 months after implantation. ECoG findings were correlated with findings from audiometric tests. Results: Extra- and intracochlear ECoG responses could be recorded in all subjects. Extracochlear ECoG recordings during surgery showed moderate changes. Loss or reduction of the ECoG signal at all three frequencies did not occur during cochlear implantation. During the first week following surgery, conductive hearing loss, due to middle ear effusion, led to a decrease in intracochlear ECoG signal amplitudes. This was not attributable to changes of cochlear function. All persistent reductions in ECoG response magnitude after normalization of the tympanogram occurred during the first week following implantation. Thresholds of ECoG signals were at or below hearing thresholds in all cases. Conclusion: Gross intracochlear trauma during surgery appears to be rare. In the early postoperative phase the ability to assess cochlear status by ECoG recordings was limited due to the regular occurrence of middle ear effusion. Still, intracochlear ECoG along with tympanogram recordings suggests that any changes of low-frequency cochlear function occur mainly during the first week after cochlear implantation. ECoG seems to be a promising tool to objectively assess changes in cochlear function in cochlear implant recipients and may allow further insight into the mechanisms underlying the loss of residual hearing.

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B043 Middle ear effusion and grommet insertion pre cochlear implantation

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/s0165-5876(11)70088-x ◽

2011 ◽

Vol 75 ◽

pp. 18

Author(s):

S. Tzortzis ◽

E. Young ◽

K. Tzifa ◽

R. Irving ◽

A. Reid

Keyword(s):

Middle Ear ◽

Cochlear Implantation ◽

Middle Ear Effusion ◽

Ear Effusion

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Impact of Electric Stimulation on Residual Hearing

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15013 ◽

2015 ◽

Vol 26 (08) ◽

pp. 732-740 ◽

Cited By ~ 3

Author(s):

Margaret T. Dillon ◽

Andrea L. Bucker ◽

Marcia C. Adunka ◽

English R. King ◽

Oliver F. Adunka ◽

...

Keyword(s):

Cochlear Implant ◽

Electric Stimulation ◽

Bone Conduction ◽

Low Frequency ◽

Electrode Array ◽

Hearing Preservation ◽

Acoustic Stimulation ◽

First Year ◽

Residual Hearing ◽

Listening Experience

Background: Candidacy criteria for cochlear implantation are expanding to include patients with substantial low-to-mid frequency hearing sensitivity. Postoperative hearing preservation has been achieved in cochlear implant recipients, though with variable outcomes. Previous investigations on postoperative hearing preservation outcomes have evaluated intraoperative procedures. There has been limited review as to whether electric stimulation influences hearing preservation. Purpose: The purpose of this analysis was to evaluate whether charge levels associated with electric stimulation influence postoperative hearing preservation within the first year of listening experience. Research Design: Retrospective analysis of unaided residual hearing and charge levels. Study Sample: Twenty-eight cochlear implant recipients with postoperative residual hearing in the operative ear and at least 12 mo of listening experience with electric-acoustic stimulation (EAS). Data Collection and Analysis: Assessment intervals included initial cochlear implant activation, initial EAS activation, and 3-, 6-, and 12-mo postinitial EAS activation. A masked low-frequency bone-conduction (BC) pure-tone average (PTA) was calculated for all participants at each assessment interval. Charge levels for each electrode were determined using the most comfortable loudness level and pulse width values. Charge levels associated with different regions of the electrode array were compared to the change in the low-frequency BC PTA between two consecutive intervals. Results: Charge levels had little to no association with the postoperative change in low-frequency BC PTA within the first year of listening experience. Conclusions: Electric charge levels do not appear to be reliably related to the subsequent loss of residual low-frequency hearing in the implanted ear within the first year of EAS listening experience.

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Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000254 ◽

2007 ◽

Vol 122 (3) ◽

pp. 246-252 ◽

Cited By ~ 36

Author(s):

S Berrettini ◽

F Forli ◽

S Passetti

Keyword(s):

Cochlear Implant ◽

Cochlear Implantation ◽

Surgical Techniques ◽

Electrode Array ◽

Lateral Wall ◽

Hearing Preservation ◽

Acoustic Stimulation ◽

Residual Hearing ◽

Electrode Arrays ◽

Electrode Insertion

AbstractThe preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear.We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing.The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.

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Simultaneous Intra- and Extracochlear Electrocochleography During Cochlear Implantation to Enhance Response Interpretation

Trends in Hearing ◽

10.1177/2331216521990594 ◽

2021 ◽

Vol 25 ◽

pp. 233121652199059

Author(s):

Leanne Sijgers ◽

Flurin Pfiffner ◽

Julian Grosse ◽

Norbert Dillier ◽

Kanthaiah Koka ◽

...

Keyword(s):

Cochlear Implant ◽

Cochlear Implantation ◽

Residual Hearing ◽

Recording Electrode ◽

Cochlear Function ◽

Study Results ◽

Signal Changes ◽

The Relationship ◽

Amplitude Decrease ◽

Harmonic Distortions

The use of electrocochleography (ECochG) for providing real-time feedback of cochlear function during cochlear implantation is receiving increased attention for preventing cochlear trauma and preserving residual hearing. Although various studies investigated the relationship between intra-operative ECochG measurements and surgical outcomes in recent years, the limited interpretability of ECochG response changes leads to conflicting study results and prevents the adoption of this method for clinical use. Specifically, the movement of the recording electrode with respect to the different signal generators in intracochlear recordings makes the interpretation of signal changes with respect to cochlear trauma difficult. Here, we demonstrate that comparison of ECochG signals recorded simultaneously from intracochlear locations and from a fixed extracochlear location can potentially allow a differentiation between traumatic and atraumatic signal changes in intracochlear recordings. We measured ECochG responses to 500 Hz tone bursts with alternating starting phases during cochlear implant insertions in six human cochlear implant recipients. Our results show that an amplitude decrease with associated near 180° phase shift and harmonic distortions in the intracochlear difference curve during the first half of insertion was not accompanied by a decrease in the extracochlear difference curve’s amplitude ( n = 1), while late amplitude decreases in intracochlear difference curves (near full insertion, n = 2) did correspond to extracochlear amplitude decreases. These findings suggest a role for phase shifts, harmonic distortions, and recording location in interpreting intracochlear ECochG responses.

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Persistent middle ear effusion in the first 3 years of life is not associated with behavior problems or parental stress

PsycEXTRA Dataset ◽

10.1037/e556882006-003 ◽

2000 ◽

Keyword(s):

Behavior Problems ◽

Middle Ear ◽

Parental Stress ◽

Middle Ear Effusion ◽

Ear Effusion

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A Clinical Research Form for Use in the Documentation of Middle Ear Effusion

Ear and Hearing ◽

10.1097/00003446-199108000-00010 ◽

1991 ◽

Vol 12 (4) ◽

pp. 296-298 ◽

Cited By ~ 4

Author(s):

Stanley Yankelowitz ◽

Judith Gravel ◽

Ina Wallace ◽

Pekka Karma

Keyword(s):

Clinical Research ◽

Middle Ear ◽

Middle Ear Effusion ◽

Ear Effusion

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Antibacterial Therapy and Middle Ear Effusions

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894760850s246 ◽

1976 ◽

Vol 85 (2_suppl) ◽

pp. 250-253 ◽

Cited By ~ 1

Author(s):

Paul A. Shurin

Keyword(s):

Drug Therapy ◽

Effective Treatment ◽

Otitis Media ◽

Middle Ear ◽

Middle Ear Effusion ◽

Prolonged Administration ◽

Antimicrobial Drugs ◽

Acute Attacks ◽

Ear Effusion

Antimicrobial drugs chosen for their activity against the causative pathogens of otitis media provide effective treatment for acute attacks. Prolonged administration of some of these agents has recently been shown to be of value in the prevention of symptomatic otitis. The role of drug therapy in the management of chronic or recurrent middle ear effusion is unknown at present.

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