Intraoperative Round Window Electrocochleography and Speech Perception Outcomes in Pediatric Cochlear Implant Recipients

Formeister, Eric J.; McClellan, Joseph H.; Merwin, William H.; Iseli, Claire; Calloway, Nathan H.; Teagle, Holly F. B.; Buchman, Craig A.; Adunka, Oliver F.; Fitzpatrick, Douglas C.

doi:10.1097/aud.0000000000000106

Cited by 38 publications

(51 citation statements)

References 29 publications

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“…Prior studies have only demonstrated the feasibility of making such recordings (Dalbert et al, 2015; Abbas et al, 2017; Koka et al, 2017) but the clinical applicability of these measures need to be addressed beyond their ability to predict audiometric thresholds. It also extends previous studies that have found correlations between intraoperative ECochG measures in CI users and speech outcomes (Fitzpatrick et al, 2013; Formeister et al, 2015). …”

Section: Discussionsupporting

confidence: 88%

“…Recent investigations have suggested that better outcomes with a traditional or Hybrid CI might be expected from individuals presenting with better overall “cochlear health” (Gantz et al, 2009; Kim et al, 2010; Fitzpatrick et al, 2013; Formeister et al, 2015). In other words, CI candidates who present with better hair cell and/or neural survival may have better outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…High level acoustic tone bursts that range in frequency from 250 to 4,000 Hz were presented. These responses were combined offline to generate a metric called the “total cochlear response” (Fitzpatrick et al, 2013; Formeister et al, 2015). Importantly, Fitzpatrick et al (2013) and Formeister et al (2015) reported a significant correlation between the magnitude of the ongoing ECochG response across several frequencies and postoperative speech perception in adults and children using standard CIs.…”

Section: Introductionmentioning

confidence: 99%

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Intracochlear Recordings of Acoustically and Electrically Evoked Potentials in Nucleus Hybrid L24 Cochlear Implant Users and Their Relationship to Speech Perception

et al. 2017

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The Hybrid cochlear implant (CI) has been developed for individuals with high frequency hearing loss who retain good low frequency hearing. Outcomes have been encouraging but individual variability is high; the health of the cochlea and the auditory nerve may be important factors driving outcomes. Electrically evoked compound action potentials (ECAPs) reflect the response of the auditory nerve to electrical stimulation while electrocochleography (ECochG) reflects the response of the cochlear hair cells and auditory nerve to acoustic stimulation. In this study both ECAPs and ECochG responses were recorded from Nucleus Hybrid L24 CI users. Correlations between these two measures of peripheral auditory function and speech perception are reported. This retrospective study includes data from 25 L24 CI users. ECAPs and ECochG responses were recorded from an intracochlear electrode using stimuli presented at or near maximum acceptable loudness levels. Speech perception was assessed using Consonant-Nucleus-Consonant (CNC) word lists presented in quiet and AzBio sentences presented at a +5 dB signal-to-noise ratio in both the combined acoustic and electric (A+E) and electric (E) alone listening modes. Acoustic gain was calculated by subtracting these two scores. Correlations between these physiologic and speech perception measures were then computed. ECAP amplitudes recorded from the most apical electrode were significantly correlated with CNC scores measured in the E alone (r = 0.56) and A+E conditions (r = 0.64), but not with performance on the AzBio test. ECochG responses recorded using the most apical electrode in the intracochlear array but evoked using a 500 Hz tone burst were not correlated with either the scores on the CNC or AzBio tests. However, ECochG amplitude was correlated with a composite metric relating the additional benefit of acoustic gain in noise relative to quiet conditions (r = 0.67). Both measures can be recorded from Hybrid L24 CI users and both ECAP and ECochG measures may result in more complete characterization of speech perception outcomes than either measure alone.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracochlear Recordings of Acoustically and Electrically Evoked Potentials in Nucleus Hybrid L24 Cochlear Implant Users and Their Relationship to Speech Perception

et al. 2017

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“…It was suggested that the unexpectedly flat responses and basal-peak responses arose from the proximity of the electrode to the auditory nerve, or the influence of intra-scalar fibrosis on the current path in the vicinity of the electrode (also suggested by Campbell et al, 2015). In contrast, Formeister et al (2015) made recordings at multiple insertion depths from a single recording electrode on a flexible carrier that was inserted into the cochlea during surgery, just prior to implantation of the commercial CI. These investigators found the relationship seen in the previous animal experiments of Honrubia and Ward (1968), with five of eight patients exhibiting a rise in CM amplitude as depth increased, in response to a 0.5-kHz tone.…”

Section: Introductionmentioning

confidence: 99%

Characterizing Electrocochleography in Cochlear Implant Recipients with Residual Low-Frequency Hearing

et al. 2017

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Objective: Lay the groundwork for using electrocochleography (ECochG) as a measure of cochlear health, by characterizing typical patterns of the ECochG response observed across the electrode array in cochlear implant recipients with residual hearing.Methods: ECochG was measured immediately after electrode insertion in 45 cochlear implant recipients with residual hearing. The Cochlear Response Telemetry system was used to record ECochG across the electrode array, in response to 100- or 110-dB SPL pure tones at 0.5-kHz, presented at 14 per second and with alternating polarities. Hair cell activity, as the cochlear microphonic (CM), was estimated by taking the difference (DIF) of the two polarities. Neural activity, as the auditory nerve neurophonic (ANN), was estimated by taking the sum (SUM) of the two polarities. Prior work in humans and animal studies suggested that the expected ECochG pattern in response to a 0.5-kHz pure tone is an apical-peak in CM amplitude and latency.Results: The most prevalent pattern was a peak in the DIF amplitude near the most apical electrode, with a prolongation of latency toward the electrode tip; this was found in 21/39 individuals with successful ECochG recordings. The 21 apical-peak recipients had the best low-frequency hearing. A low amplitude, long-latency DIF response that remained relatively constant across the electrode array was found in 10/39 individuals, in a group with the poorest low- and high-frequency hearing. A third, previously undescribed, pattern occurred in 8/39 participants, with mid-electrode peaks in DIF amplitude. These recipients had the best high-frequency hearing and a progressive prolongation of DIF latency around the mid-electrode peaks consistent with the presence of discrete populations of hair cells.Conclusions: The presence of distinct patterns of the ECochG response with relationships to pre-operative hearing levels supports the notion that ECochG across the electrode array functions as a measure of cochlear health.

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“…Intraoperative recording from the round window or from the promontory during cochlear implant surgery has also been reported about in a recent series of articles (Mandalà et al, 2012; Calloway et al, 2014; McClellan et al, 2014; Dalbert et al, 2015a; Formeister et al, 2015; Adunka et al, 2016). I will not dwell on this ECochG use as it will be part of another set of articles in this Special Topic.…”

Section: Current Interestmentioning

confidence: 86%

Ups and Downs in 75 Years of Electrocochleography

Eggermont

2017

Front. Syst. Neurosci.

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Before 1964, electrocochleography (ECochG) was a surgical procedure carried out in the operating theatre. Currently, the newest application is also an intra-operative one, often carried out in conjunction with cochlear implant surgery. Starting in 1967, the recording methods became either minimal- or not-invasive, i.e., trans-tympanic (TT) or extra tympanic (ET), and included extensive studies of the arguments pro and con. I will review several valuable applications of ECochG, from a historical point of view, but covering all 75 years if applicable. The main topics will be: (1) comparing human and animal cochlear electrophysiology; (2) the use in objective audiometry involving tone pip stimulation—currently mostly pre cochlear implantation but otherwise replaced by auditory brainstem response (ABR) recordings; (3) attempts to diagnose Ménière’s disease and the role of the summating potential (SP); (4) early use in diagnosing vestibular schwannomas—now taken over by ABR screening and MRI confirmation; (5) relating human electrophysiology to the effects of genes as in auditory neuropathy; and (6) intracochlear recording using the cochlear implant electrodes. The last two applications are the most recently added ones. The “historical aspects” of this review article will highlight the founding years prior to 1980 when relevant. A survey of articles on Pubmed shows several ups and downs in the clinical interest as reflected in the publication counts over the last 75 years.

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Intraoperative Round Window Electrocochleography and Speech Perception Outcomes in Pediatric Cochlear Implant Recipients

Cited by 38 publications

References 29 publications

Intracochlear Recordings of Acoustically and Electrically Evoked Potentials in Nucleus Hybrid L24 Cochlear Implant Users and Their Relationship to Speech Perception

Intracochlear Recordings of Acoustically and Electrically Evoked Potentials in Nucleus Hybrid L24 Cochlear Implant Users and Their Relationship to Speech Perception

Characterizing Electrocochleography in Cochlear Implant Recipients with Residual Low-Frequency Hearing

Ups and Downs in 75 Years of Electrocochleography

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