Remote Intraoperative Neural Response Telemetry: Technique and Results in Cochlear Implant Surgery

Abstract

ObjectivePresent results with remote intraoperative neural response telemetry (NRT) during cochlear implantation (CI) and its usefulness in overcoming the inefficiency of in person NRT.Study DesignCase series.SettingTertiary academic otology practice.PatientsAll patients undergoing primary or revision CI, both adult and pediatric, were enrolled.InterventionsRemote intraoperative NRT performed by audiologists using a desktop computer to control a laptop in the operating room. Testing was performed over the hospital network using commercially available software. A single system was used to test all three FDA-approved manufacturers’ devices.Main Outcome MeasuresSuccess rate and time savings of remote NRT.ResultsOut of 254 procedures, 252 (99.2%) underwent successful remote NRT. In two procedures (0.7%), remote testing was unsuccessful, and required in-person testing to address technical issues.Both failed attempts were due to hardware failure (OR laptop or headpiece problems). There was no relation between success of the procedure and patient/surgical factors such as difficult anatomy, or the approach used for inner ear access. The audiologist time saved using this approach was considerable when compared with in-person testing.ConclusionsRemote intraoperative NRT testing during cochlear implantation can be performed effectively using standard hardware and remote-control software. Especially important during the Covid-19 pandemic, such a procedure can reduce in-person contacts, and limit the number of individuals in the operating room. Remote testing can provide additional flexibility and efficiency in audiologist schedules.