Amplitude and Phase Changes in Electrocochleographic Real-Time Recordings During Cochlear Implantation and Its Relation to Pre- and Postoperative Hearing.
Adrian Dalbert, Christofer Bester, Aaron Collins, Tayla Razmovski, Jean-Marc Gerard, Stephen O'Leary
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引用次数: 0
Abstract
Background: The aim of this study was to relate response patterns of electrocochleography (ECochG) recordings during cochlear implantation to pre- and postoperative hearing.
Methods: Thirty subjects with either flat (FA, n = 9) or sloping (SA, n = 21) audiograms before cochlear implantation were prospectively included. Real-time ECochG recordings were conducted via the cochlear implant. The difference curve (DIF) signal of the ECochG recordings was analyzed regarding alteration of the waveform, amplitude changes, and relative phase shifts during insertion.
Results: Five subjects (56%) with FA and 13 (62%) with SA exhibited DIF signal drops in the early phase of the insertion. In subjects with FA, alterations of the DIF signal waveform in the early phase of the insertion occurred in 8 subjects (90%), whereas such changes were detectable in only 2 out of 21 subjects (10%) with SA ( p < 0.001). DIF signal drops with relative phase shifts of >0.7 radians but without alterations of the waveform occurred in 5 subjects (56%) with FA and 11 (52%) with SA. Such drops were associated with larger postoperative hearing losses than DIF signal drops without phase changes in both groups (FA: 43 versus 20 dB, p = 0.045; SA: 30 versus 14 dB, p = 0.001).
Conclusion: Residual cochlear function in basal regions leads to alteration of the DIF signal waveform during insertion, probably not associated with cochlear injury. A decrease of the DIF signal amplitude with a simultaneous relative phase shift but no alteration of the waveform is associated with greater loss of residual hearing independent from the preoperative hearing.
背景：本研究的目的是将人工耳蜗植入过程中耳蜗电图（ECochG）记录的反应模式与术前和术后听力联系起来。方法：前瞻性纳入30例耳蜗植入前扁平（FA, n = 9）或倾斜（SA, n = 21）听音图的受试者。通过人工耳蜗进行实时ECochG记录。分析ECochG记录的差分曲线（DIF）信号在插入期间的波形变化、幅度变化和相对相移。结果：FA组5例（56%），SA组13例（62%）在插入早期出现DIF信号下降。在FA患者中，8名受试者（90%）在插入早期出现了DIF信号波形的改变，而在21名SA患者中只有2名（10%）检测到这种变化（p < 0.001）。FA组有5例（56%），SA组有11例（52%），DIF信号随相对相移而下降，但波形没有改变。在两组中，与无相位变化的DIF信号下降相比，这种下降与更大的术后听力损失相关(FA: 43对20 dB， p = 0.045；SA: 30 vs 14 dB, p = 0.001)。结论：基底区耳蜗功能的残留导致了植入时DIF信号波形的改变，可能与耳蜗损伤无关。DIF信号幅度下降，同时出现相对相移，但波形没有改变，与术前听力无关的残余听力损失更大有关。
期刊介绍：
Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.
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