Round Window Electrocochleography and Speech Perception Outcomes in Adult Cochlear Implant Subjects

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

doi:10.1097/mao.0000000000000557

Cited by 55 publications

(85 citation statements)

References 20 publications

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“…This definition has been used in multiple studies (27,(30)(31)(32)). An ongoing ECoG response was considered valid if the amplitude exceeded the mean noise floor plus 3 standard deviations (9,10,25,(29)(30)(31)(32). This means that less than 1% false-positive results can be expected.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography

Dalbert

Huber

Veraguth

et al. 2016

Otology &Amp; Neurotology

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Section: Discussionmentioning

confidence: 99%

Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography

Dalbert

Huber

Veraguth

et al. 2016

Otology &Amp; Neurotology

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“…It has been shown that the ECoG magnitude is a strong predictor for cochlear implant performance in postlingually deafened adults and children (15,17,18). To our knowledge, 2 reports have been published correlating intraoperative ECoG with hearing preservation after surgery.…”

mentioning

confidence: 91%

Correlation of Electrophysiological Properties and Hearing Preservation in Cochlear Implant Patients

Dalbert

Sim

Gerig

et al. 2015

Otology &Amp; Neurotology

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OBJECTIVE: To monitor changes in cochlear function during cochlear implantation using electrocochleography (ECoG) and to correlate changes to postoperative hearing preservation. METHODS: ECoG responses to acoustic stimuli of 250, 500, and 1000 Hz were recorded during cochlear implantation. The recording electrode was placed on the promontory and stabilized to fix the position during cochlear implantation. Baseline recordings were obtained after completion of the posterior tympanotomy. Changes of the ongoing ECoG response at suprathreshold intensities were analyzed after full insertion of the cochlear implant electrode array. Audiometric tests were conducted before and 4 weeks after surgery and correlated with electrophysiological findings. RESULTS: Ninety-five percent (18/19) of cochlear implant subjects had measurable ECoG responses. Under unchanged conditions, recordings showed a high repeatability without significant differences between 2 recordings (p 0.01). Ninety-four percent (17/18) of subjects showed no relevant changes in ECoG recordings after insertion of the cochlear implant electrode array. One subject showed decreases in responses at all frequencies indicative of cochlear trauma. This was associated with a complete hearing loss 4 weeks after surgery compared with mean presurgical low-frequency hearing of 78 dB HL. CONCLUSION: Extracochlear ECoG is a reliable tool to assess cochlear function during cochlear implantation. Moderate threshold shifts could be caused by postoperative mechanisms or minor cochlear trauma. Detectable changes in extracochlear ECoG recordings, indicating gross cochlear trauma, are probably predictive of complete loss of residual acoustic hearing.

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“…Using ECochG, the electrical response of the cochlea to sound can be recorded prior to implantation. Measurements of the “total response” (TR), accounted for 40–50% of variance in speech recognition outcomes at 6 months 10,11 . The TR is the sum of the spectral magnitudes of the ongoing, or steady-state, response to a series of tone bursts of different frequencies.…”

Section: Introductionmentioning

confidence: 99%

The Compound Action Potential in Subjects Receiving a Cochlear Implant

Scott

Giardina

Pappa

et al. 2016

Otology &Amp; Neurotology

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Hypothesis The compound action potential (CAP) is a purely neural component of the cochlea’s response to sound, and may provide information about the existing neural substrate in cochlear implant (CI) subjects that can help account for variance in speech perception outcomes. Background Measurement of the ‘total response’ (TR), or sum of the magnitudes of spectral components in the ongoing responses to tone bursts across frequencies, has been shown to account for 40–50% of variance in speech perception outcomes. The ongoing response is composed of both hair cell and neural components. This correlation may be improved with the addition of the CAP. Methods Intraoperative round window electrocochleography (ECochG) was performed in adult and pediatric CI subjects (n=238). Stimuli were tones of different frequencies (250 Hz–4 kHz) at 90 dB nHL. The CAP was assessed in two ways, as an amplitude and with a scaling factor derived from a function fitted to the response. The results were correlated with CNC word scores at 6 months post-implantation (n=51). Results Only about half of the subjects had a measurable CAP at any frequency. The consonant-nucleus-consonant (CNC) word scores correlated weakly with both amplitude (r2=0.20, p < 0.001) and scaling factor (r2=0.25, p < 0.01). In contrast, the TR alone accounted for 43% of the variance, and addition of either CAP measurement in multiple regression did not account for additional variance. Conclusions The underlying pathology in CI patients causes the CAP to be often absent and highly variable when present. The TR is a better predictor of speech perception outcomes than the CAP.

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Round Window Electrocochleography and Speech Perception Outcomes in Adult Cochlear Implant Subjects

Abstract: The measurement of cochlear physiology before CI, reduced to a single variable, is a better predictor of postoperative speech perception than common clinical factors. Additional analysis of the outliers showed that waveform morphology can provide distinct information in individual cases.

Cited by 55 publications

References 20 publications

Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography

Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography

Correlation of Electrophysiological Properties and Hearing Preservation in Cochlear Implant Patients

The Compound Action Potential in Subjects Receiving a Cochlear Implant

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