Electrocochleography Latency: Correlation With Electrode Position During Cochlear Implantation.

IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Raphael R Andonie, Wilhelm Wimmer, Reto A Wildhaber, Georgios Mantokoudis, Marco Caversaccio, Stefan Weder
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引用次数: 0

Abstract

Objectives: Cochlear implant (CI) candidates increasingly exhibit some degree of residual hearing, which should be preserved despite the implantation. Today, cochlear health is monitored during CI surgery by tracking the cochlear microphonic (CM) amplitude from intracochlear electrocochleography (ECochG) measurements. However, recent studies indicate that the insertion depth of the measuring electrode must be considered to accurately interpret these signals. The acoustic path from the cochlear base to the apex induces excitation delays in deeper regions, which should be reflected in the CM measurements. In this study, we analyzed the potential of cochlear microphonic latency (CML) as an objective method for continuously tracking CI electrode position during cochlear implantation. In addition, we examined whether CML can be associated with residual hearing.

Design: We recorded intraoperative pure-tone ECochG at maximum stimulation levels from 30 CI patients to derive CML. During CI electrode insertion, ECochG was continuously recorded at the 2 stimulation frequencies of 0.5 and 0.75 kHz. After complete insertion, ECochG was measured on all evenly numbered electrodes at frequencies of 0.25, 0.5, 0.75, and 1 kHz. The electrode locations (i.e., linear insertion depth) were identified by postoperative computed tomography (CT) scans. The location of the measuring electrode during the insertion period was then calculated backward, assuming a constant insertion speed. Finally, we used a linear regression model to relate CML to linear insertion depth. In addition, we evaluated the relationship between CML and preoperative residual hearing.

Results: CML is significantly correlated to the linear insertion depth (p < 0.001) during and after electrode insertion (with restrictions on 0.25 kHz stimulus, presumably since the characteristic 0.25 kHz region is not within reach of the used CI electrode arrays). Despite high inter-individual variability, our results align with documented delays in the basilar membrane observed in other studies. However, we could not identify a significant association between CML and residual hearing.

Conclusions: Our study demonstrates that objectively extracted CML encodes the intracochlear electrode location in CI patients but is not directly linked to residual hearing. Consequently, CML has the potential to enhance intraoperative ECochG analysis by providing real-time tracking of electrode position. To better understand the inter-individual variations in CML, future studies with larger patient cohorts are needed.

目的:越来越多的人工耳蜗(CI)植入者表现出一定程度的残余听力,尽管植入了人工耳蜗,但仍应保留残余听力。如今,在进行人工耳蜗植入手术时,可通过蜗内耳蜗电图(ECochG)测量跟踪耳蜗微音(CM)振幅来监测耳蜗健康状况。然而,最近的研究表明,要准确解释这些信号,必须考虑测量电极的插入深度。从耳蜗基底到顶点的声学路径会在更深的区域引起激励延迟,这应反映在 CM 测量中。在本研究中,我们分析了人工耳蜗微音潜伏期(CML)作为在人工耳蜗植入过程中持续跟踪 CI 电极位置的客观方法的潜力。此外,我们还研究了 CML 是否与残余听力有关:设计:我们在最大刺激水平下记录了 30 名 CI 患者的术中纯音 ECochG,以得出 CML。在插入 CI 电极期间,连续记录 0.5 和 0.75 kHz 两个刺激频率下的心电图。完全插入后,以 0.25、0.5、0.75 和 1 kHz 的频率测量所有偶数电极的心电图。电极位置(即线性插入深度)由术后计算机断层扫描(CT)确定。然后,假设插入速度不变,反向计算插入期间测量电极的位置。最后,我们使用线性回归模型将 CML 与线性插入深度联系起来。此外,我们还评估了 CML 与术前残余听力之间的关系:结果:在电极插入过程中和插入后,CML 与线性插入深度明显相关(p < 0.001)(对 0.25 kHz 刺激有限制,这可能是因为所使用的 CI 电极阵列无法触及 0.25 kHz 特性区域)。尽管个体间差异很大,但我们的结果与其他研究中观察到的基底膜延迟记录一致。然而,我们无法确定基底膜延迟与残余听力之间存在显著关联:我们的研究表明,客观提取的 CML 编码了 CI 患者耳蜗内电极的位置,但与残余听力没有直接联系。因此,CML 有可能通过实时跟踪电极位置来增强术中心电图分析。为了更好地了解 CML 的个体间差异,未来需要对更大的患者群体进行研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ear and Hearing
Ear and Hearing 医学-耳鼻喉科学
CiteScore
5.90
自引率
10.80%
发文量
207
审稿时长
6-12 weeks
期刊介绍: From the basic science of hearing and balance disorders to auditory electrophysiology to amplification and the psychological factors of hearing loss, Ear and Hearing covers all aspects of auditory and vestibular disorders. This multidisciplinary journal consolidates the various factors that contribute to identification, remediation, and audiologic and vestibular rehabilitation. It is the one journal that serves the diverse interest of all members of this professional community -- otologists, audiologists, educators, and to those involved in the design, manufacture, and distribution of amplification systems. The original articles published in the journal focus on assessment, diagnosis, and management of auditory and vestibular disorders.
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