1
|
Effect of Electrode to Modiolus Distance on Electrophysiological and Psychophysical Parameters in CI Patients With Perimodiolar and Lateral Electrode Arrays. Otol Neurotol 2020; 41:e1091-e1097. [DOI: 10.1097/mao.0000000000002751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
2
|
Weiss NM, Óvári A, Oberhoffner T, Demaret L, Bicer A, Schraven S, Ehrt K, Dahl R, Schneider A, Mlynski R. Automated detection of electrically evoked stapedius reflexes (eSR) during cochlear implantation. Eur Arch Otorhinolaryngol 2020; 278:1773-1779. [PMID: 32748185 PMCID: PMC8131305 DOI: 10.1007/s00405-020-06226-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/17/2020] [Indexed: 12/01/2022]
Abstract
Introduction In cochlear implantation, objective fitting methods are needed to optimize audiological results in small children or patients with poor compliance. Intraoperatively measured electrically evoked stapedius reflexes (eSR) can be used as a marker for the patient’s discomfort level. The aim of this study was to develop and evaluate an automated detection method for eSR and to compare it to the detection rate of the surgeon and independent observers. Methods Cochlear implantation using a fully digital surgical microscope was performed. Movements of the stapedius tendon were recorded and analyzed by means of computer vision technique. Differences in eSR elicited by stimulating electrodes at different cochlear locations (basal, middle and apical) were analyzed. The eSR detection rate of the image processing algorithm was compared to the surgeon’s detection rate and to those of two less experienced observers. Results A total of 387 electrically impulses were applied. The stimulation of middle turn electrodes showed significantly higher detection rates (50.4%) compared to the basal (40.0%; p = 0.001) and apical (43.6%; p = 0.03) turn. The software identified significantly more of the applied stimuli (58.4%) compared to the surgeon (46.3%; p = 0.0007), the intermediate observer (37.7%; p < 0.0001) and the unexperienced observer (41.3%; p < 0.0001). Conclusion The feasibility of an automated intraoperative software-based detection of eSR is demonstrated. By improving the eSR detection methods and their clinical applicability, their utility in objective cochlear implant fitting may be substantially increased.
Collapse
Affiliation(s)
- Nora M Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Attila Óvári
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Tobias Oberhoffner
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | | | - Atabek Bicer
- ARRI Medical GmbH, Türkenstraße 89, 80799, München, Germany
| | - Sebastian Schraven
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Karsten Ehrt
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Rüdiger Dahl
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | | | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.
| |
Collapse
|
3
|
Perenyi A, Toth F, Dimak B, Nagy R, Schoerg P, Jori J, Kiss JG, Sprinzl G, Csanady M, Rovo L. Electrophysiological measurements with electrode types of different perimodiolar properties and the same cochlear implant electronics - a retrospective comparison study. J Otolaryngol Head Neck Surg 2019; 48:46. [PMID: 31492190 PMCID: PMC6731597 DOI: 10.1186/s40463-019-0361-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/20/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- A Perenyi
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary.
| | - F Toth
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - B Dimak
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - R Nagy
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - P Schoerg
- Karl Landsteiner University Hospital of StPölten, Propst-Führer-Straße 4, 3100, St. Pölten, Austria
| | - J Jori
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - J G Kiss
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - G Sprinzl
- Karl Landsteiner University Hospital of StPölten, Propst-Führer-Straße 4, 3100, St. Pölten, Austria
| | - M Csanady
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| | - L Rovo
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Tisza Lajos krt. 111, Szeged, H-6725, Hungary
| |
Collapse
|
4
|
Qiao XF, Li X, Zhang QW, Li TL, Wang D. Postoperative objective detecting techniques for cochlear implant children with inner ear malformation. Int J Pediatr Otorhinolaryngol 2017; 102:1-6. [PMID: 29106852 DOI: 10.1016/j.ijporl.2017.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study aims to investigate the changing characteristics and rules of electrically-evoked auditory brainstem response (EABR), electrically-evoked stapedius reflex threshold (ESRT) and neural response telemetry (NRT) after cochlear implant in children with inner ear malformation, and guide postoperative equipment debug. METHODS A total of 88 children with either normal cochlea (control group) or inner ear malformation (test group) received Australian 24 multi-channel cochlear implants. The EABR, ESRT and NRT thresholds at different time points within one year postoperatively and behavioral responses (T-level and C-level) after one year were detected. Furthermore, the changing characteristics and rules of these thresholds were analyzed. RESULTS The EABR, ESRT and NRT thresholds were all significantly higher at all time points in the test group than in the control group, but the general changing trends were similar. Particularly, these thresholds worsened at low frequencies and improved at high frequencies. Furthermore, EABR, ESRT and NRT thresholds gradually increased during the one year postoperative period. In addition, an extremely significant correlation was found between EABR and T-level and between ESRT and C-level, but a less significant correlation was found between NRT threshold and T-level in both groups. CONCLUSIONS The postoperative changes in characteristics and rules of EABR, ESRT and NRT thresholds among cochlear implant children with inner ear malformation were all the same as those with normal cochlea. Thus, these thresholds can be used to guide the postoperative equipment debug for cochlear implants into patients with inner ear malformation.
Collapse
Affiliation(s)
- Xiao-Feng Qiao
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China.
| | - Xin Li
- Department of Surgery, Children's Hospital of Shanxi Province, Taiyuan 030001, China
| | - Qiang-Wei Zhang
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| | - Tong-Li Li
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| | - Dong Wang
- Department of Otorhinolaryngology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030001, China
| |
Collapse
|
5
|
Lathuillière M, Merklen F, Piron JP, Sicard M, Villemus F, Menjot de Champfleur N, Venail F, Uziel A, Mondain M. Cone-beam computed tomography in children with cochlear implants: The effect of electrode array position on ECAP. Int J Pediatr Otorhinolaryngol 2017; 92:27-31. [PMID: 28012529 DOI: 10.1016/j.ijporl.2016.10.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the feasibility of using cone-beam computed tomography (CBCT) in young children with cochlear implants (CIs) and study the effect of intracochlear position on electrophysiological and behavioral measurements. METHODS A total of 40 children with either unilateral or bilateral cochlear implants were prospectively included in the study. Electrode placement and insertion angles were studied in 55 Cochlear® implants (16 straight arrays and 39 perimodiolar arrays), using either CBCT or X-ray imaging. CBCT or X-ray imaging were scheduled when the children were leaving the recovery room. We recorded intraoperative and postoperative neural response telemetry threshold (T-NRT) values, intraoperative and postoperative electrode impedance values, as well as behavioral T (threshold) and C (comfort) levels on electrodes 1, 5, 10, 15 and 20. RESULTS CBCT imaging was feasible without any sedation in 24 children (60%). Accidental scala vestibuli insertion was observed in 3 out of 24 implants as assessed by CBCT. The mean insertion angle was 339.7°±35.8°. The use of a perimodiolar array led to higher angles of insertion, lower postoperative T-NRT, as well as decreased behavioral T and C levels. We found no significant effect of either electrode array position or angle of insertion on electrophysiological data. CONCLUSION CBCT appears to be a reliable tool for anatomical assessment of young children with CIs. Intracochlear position had no significant effect on the electrically evoked compound action potential (ECAP) threshold. Our CBCT protocol must be improved to increase the rate of successful investigations.
Collapse
Affiliation(s)
- Marine Lathuillière
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France.
| | - Fanny Merklen
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | - Jean-Pierre Piron
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | - Marielle Sicard
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | - Françoise Villemus
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | | | - Frédéric Venail
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | - Alain Uziel
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| | - Michel Mondain
- Cochlear Implant Centre, Ear Nose and Throat Department, University Hospital Gui-de-Chauliac, Montpellier, France
| |
Collapse
|
6
|
|
7
|
|