Utility of intraoperative neural response telemetry in pediatric cochlear implants

Sawaf, Tuleen; Vovos, Rachel; Hadford, Stephen; Woodson, Erika; Anne, Samantha

doi:10.1016/j.ijporl.2022.111298

Cited by 3 publications

(7 citation statements)

References 34 publications

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“…A detectable response signifies that the implant is firing successfully. 1 This also helps to verify the insertion of electrodes in the cochlea and tests the functioning of electrodes intraoperatively. Therefore, using NRT and normal saline, a malfunctioning CI was brought back to life.…”

Section: Introductionmentioning

confidence: 99%

Troubleshooting Cochlear Implant Malfunction Using Neural Response Telemetry and Normal Saline

Sagar,

Kumar

et al. 2024

The Journal of International Advanced Otology

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Cochlear implantation has become a standard of care for a child diagnosed with bilateral profound sensorineural hearing loss with a structured surgical standard operating procedure. A 3-year-old boy with bilateral profound prelingual sensorineural deafness underwent a Med-EL Sonata Ti100 implant. We faced a peculiar situation intraoperatively after inserting the electrodes and closing the wound. The impedance recording indicated high ground path impedance with short-circuiting of few electrodes. As a bionic implant, its electronic components may at times malfunction both intraoperatively and/or postoperatively; therefore, neural response telemetry (NRT) was invented to check it. By using NRT and a few milliliters of normal saline, we were able to diagnose as well as rectify the malfunctioning of the implant.

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Section: Introductionmentioning

confidence: 99%

Troubleshooting Cochlear Implant Malfunction Using Neural Response Telemetry and Normal Saline

Sagar,

Kumar

et al. 2024

The Journal of International Advanced Otology

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“…8 These responses are recorded as electrical compound action potential (ECAP) measurements, which can help with evaluating the function and placement of the electrode intraoperatively and can be useful in programming postoperatively, especially in children. 9 NRT can be performed both intraoperatively, often concomitantly at the time of skin flap closure, and at subsequent postoperative outpatient visits. Previous studies have demonstrated that intraoperative NRT strongly correlates with postoperative electrode function and thus serves as an instant tool to optimize cochlear implant programming.…”

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confidence: 99%

“…Previous studies have demonstrated that intraoperative NRT strongly correlates with postoperative electrode function and thus serves as an instant tool to optimize cochlear implant programming. 9 However, whether intraoperative NRT predicts functional auditory outcomes is unknown.…”

mentioning

confidence: 99%

“…Neural response telemetry (NRT) is a noninvasive, quantitative method to assess neural responses to the electrode array 8 . These responses are recorded as electrical compound action potential (ECAP) measurements, which can help with evaluating the function and placement of the electrode intraoperatively and can be useful in programming postoperatively, especially in children 9 . NRT can be performed both intraoperatively, often concomitantly at the time of skin flap closure, and at subsequent postoperative outpatient visits.…”

mentioning

confidence: 99%

“…NRT can be performed both intraoperatively, often concomitantly at the time of skin flap closure, and at subsequent postoperative outpatient visits. Previous studies have demonstrated that intraoperative NRT strongly correlates with postoperative electrode function and thus serves as an instant tool to optimize cochlear implant programming 9 . However, whether intraoperative NRT predicts functional auditory outcomes is unknown.…”

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confidence: 99%

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Intraoperative Neural Response Telemetry and Auditory Outcomes in Pediatric Cochlear Implantation

Sawaf

Vovos

et al. 2023

Otolaryngol.--head neck surg.

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Objective To evaluate the relationship between intraoperative neural response telemetry (NRT) and postoperative auditory testing outcomes in children. Study Design Retrospective study. Setting Tertiary‐care academic center. Methods Children who underwent cochlear implantation using the Cochlear Corporation device between 2010 and 2019 were included. Associations of average NRT and the slope of amplitude with postoperative auditory outcomes including functional auditory measure Infant‐Toddler Meaningful Auditory Integration Scale (IT‐MAIS), and speech perception testing (consonant‐nucleus‐consonant [CNC], Pediatric AzBio [BABY BIO], Hearing In Noise Test [HINT], and Northwestern University Children's Perception of Speech [NU‐CHIPS]), measured between 6 and 57 months after implantation, were assessed using Spearman's rank correlation (ρ). Results Thirty‐eight patients (19 female, 19 male) and 54 ears were included. The median age of implantation was 20.6 months (range 9.6 months to 10.6 years). Eight (21%) children had neurologic disorders such as stroke, epilepsy, cerebral palsy, and other causes. Thirteen (34%) children had connexin mutations. Average NRT was not significantly correlated with postoperative auditory outcomes (IT‐MAIS [ρ = −0.08, p = .74], CNC [ρ = 0.19, p = .32], BABY BIO [ρ = 0.21, p = .29], HINT [ρ = 0.05, p = .83]) and NU‐CHIPS (ρ = 0.21, p = .28). The average slopes of amplitude and comfort level were not strongly correlated with any auditory outcomes (p > .05). Conclusions Intraoperative NRT was not correlated with any postoperative functional auditory outcomes. Patient counseling should include discussions that a subpar intraoperative cochlear response does not preclude favorable speech and auditory outcomes.

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An Umbrella Review of Cochlear Implant Outcomes in Children With Auditory Neuropathy

Jafari,

Fitzpatrick,

Schramm

et al. 2023

J Speech Lang Hear Res

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Purpose: The objective of this overview of systematic reviews (SRs; umbrella review) was to systematically summarize and critically appraise current evidence of cochlear implant (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). Method: This study was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. The methodological quality and the risk of bias in the included SRs were assessed using A MeaSurement Tool to Assess systematic Reviews 2 checklist and the Risk of Bias in Systematic Reviews tool, respectively. Results: According to eight included SRs, children with ANSD achieve CI outcomes (speech perception performance) similar to their peers with sensorineural hearing loss. In children with postsynaptic ANSD (cochlear nerve deficiency), cochlear nerve hypoplasia is associated with better speech recognition outcomes compared with cochlear nerve aplasia, especially in the absence of additional disabilities. Except for one study, the overall quality of the included SRs was critically low, and except for three studies, evidence of a high risk of bias was identified in other included SRs. Conclusions: Current evidence supports CI benefits for children with ANSD. To improve the quality of evidence, well-designed, prospective studies with appropriate sample sizes, using valid outcome measures, clarifying matching criteria, and taking into account the role of confounding factors are essential.

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Utility of intraoperative neural response telemetry in pediatric cochlear implants

Cited by 3 publications

References 34 publications

Troubleshooting Cochlear Implant Malfunction Using Neural Response Telemetry and Normal Saline

Troubleshooting Cochlear Implant Malfunction Using Neural Response Telemetry and Normal Saline

Intraoperative Neural Response Telemetry and Auditory Outcomes in Pediatric Cochlear Implantation

An Umbrella Review of Cochlear Implant Outcomes in Children With Auditory Neuropathy

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