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Yathiraj A, Manjula P, Geetha C, Jawahar Antony P, Megha. Comparison of electrically evoked stapedial reflexes in patients with cochlear implants surgically implanted using Veria and posterior tympanotomy approaches. J Laryngol Otol 2024:1-6. [PMID: 38311334 DOI: 10.1017/s0022215124000227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The study aimed to compare ipsilateral and contralateral electrically evoked stapedial reflex thresholds in children with a unilateral cochlear implant surgically implanted either through Veria or posterior tympanotomy approaches. METHODS Forty-nine children using cochlear implants were studied, of whom 27 underwent the Veria approach and 22 underwent the posterior tympanotomy approach. The electrically evoked stapedius reflex thresholds were measured ipsilaterally and contralaterally by stimulating four equally spaced electrodes. RESULTS The ipsilateral electrically evoked stapedius reflex threshold was absent in all four electrodes in the children implanted using the Veria approach. However, the ipsilateral electrically evoked stapedius reflex threshold was present in 70 per cent of the children implanted using the posterior tympanotomy approach. The contralateral electrically evoked stapedius reflex threshold was present in most of the children for both surgical approaches. CONCLUSION The presence of the ipsilateral electrically evoked stapedius reflex threshold varies depending on the surgical technique used for cochlear implantation. However, contralateral reflexes are present in the majority of children using cochlear implants, irrespective of the surgical approach.
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Affiliation(s)
- A Yathiraj
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
| | - P Manjula
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
| | - C Geetha
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
| | - P Jawahar Antony
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
| | - Megha
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
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Tyagi Y, Chatterjee I. The effect of cochlear implant age and duration of intervention on ESRT in children with cochlear implant. Cochlear Implants Int 2023:1-11. [PMID: 37302120 DOI: 10.1080/14670100.2023.2221048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To study the effect of cochlear implant age and duration of the intervention (auditory rehabilitation post-cochlear implantation) on ESRT in children with cochlear implants. METHODS A total of 90 pre-lingual cochlear implant users were included. For the measurement of ESRTs the recipient's processor was connected to the programming pod and electrode numbers 22, 11 and 3 (apical, middle and basal), respectively, were activated to give stimulation sequentially and elicit deflection as a response. RESULTS There were significant differences in the measured T, C and ESRT levels with respect to the duration of the intervention (auditory rehabilitation post-cochlear implantation) and cochlear implant age obtained at p < 0.05*, 0.01**. DISCUSSION The differences in the T, C and ESRT levels after continued device usage and after attending auditory rehabilitation sessions post-cochlear implantation are subjected to optimal benefit from implantation during the critical period. CONCLUSION The differences in T, C and ESRT levels can be utilised clinically to study the importance of duration of cochlear implant device usage and the importance of auditory rehabilitation post-cochlear implantation in children with cochlear implantation.
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Affiliation(s)
- Yashika Tyagi
- Masters in Audiology & Speech Language Pathology, AYJNISHD(D), RC, Kolkata, India
| | - Indranil Chatterjee
- Masters in Audiology & Speech Language Pathology, AYJNISHD(D), RC, Kolkata, India
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3
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Müller-Deile J, Neben N, Dillier N, Büchner A, Mewes A, Junge F, Lai W, Schuessler M, Hey M. Comparisons of electrophysiological and psychophysical fitting methods for cochlear implants. Int J Audiol 2023; 62:118-128. [PMID: 34964676 DOI: 10.1080/14992027.2021.2015543] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study compared two different versions of an electrophysiology-based software-guided cochlear implant fitting method with a procedure employing standard clinical software. The two versions used electrically evoked compound action potential (ECAP) thresholds for either five or all twenty-two electrodes to determine sound processor stimulation level profiles. Objective and subjective performance results were compared between software-guided and clinical fittings. DESIGN Prospective, double-blind, single-subject repeated-measures with permuted ABCA sequences. STUDY SAMPLE 48 post linguistically deafened adults with ≤15 years of severe-to-profound deafness who were newly unilaterally implanted with a Nucleus device. RESULTS Speech recognition in noise and quiet was not significantly different between software- guided and standard methods, but there was a visit/learning-effect. However, the 5-electrode method gave scores on the SSQ speech subscale 0.5 points lower than the standard method. Clinicians judged usability for all methods as acceptable, as did subjects for comfort. Analysis of stimulation levels and ECAP thresholds suggested that the 5-electrode method could be refined. CONCLUSIONS Speech recognition was not inferior using either version of the electrophysiology-based software-guided fitting method compared with the standard method. Subject-reported speech perception was slightly inferior with the five-electrode method. Software-guided methods saved about 10 min of clinician's time versus standard fittings.
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Affiliation(s)
- Joachim Müller-Deile
- Audiology Consultant, Kiel-Holtenau, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Nicole Neben
- Cochlear Deutschland GmbH & Co. KG, Karl-Wiechert-Allee 76A, Hannover, Germany
| | - Norbert Dillier
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Andreas Büchner
- German Hearing Centre at Hannover Medical School, Hannover, Germany
| | - Alexander Mewes
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Friederike Junge
- Cochlear Deutschland GmbH & Co. KG, Karl-Wiechert-Allee 76A, Hannover, Germany
| | - Waikong Lai
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland.,Next Sense Cochlear Implant Program, Australian Hearing Hub, Macquarie University, Sydney, Australia
| | - Mark Schuessler
- German Hearing Centre at Hannover Medical School, Hannover, Germany
| | - Matthias Hey
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany
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Guntinas-Lichius O, Arnold D, Volk GF, Korth D, Aschenbach R, Hempel JM, Schneider F, Schade-Mann T, Gamerdinger P, Tropitzsch A, Löwenheim H. Accessing the stapedius muscle via novel surgical retrofacial approach during cochlear implantation surgery: Intraoperative results on feasibility and safety. PLoS One 2022; 17:e0272943. [PMID: 35951500 PMCID: PMC9371293 DOI: 10.1371/journal.pone.0272943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022] Open
Abstract
Human stapedius muscle (SM) can be directly and safely accessed via retrofacial approach, opening new approaches to directly measure the electrically evoked stapedius reflex threshold (eSRT). The measurement of the SM activity via direct surgical access represents a potential tool for objective eSRT fitting of cochlear implants (CI), increasing the benefit experienced by the CI users and leading to new perspectives in the development of smart implantable neurostimulators. 3D middle-ear reconstructions created after manual segmentation and related SM accessibility metrics were evaluated before the CI surgery for 16 candidates with assessed stapedius reflex. Retrofacial approach to access the SM was performed after facial recess exposure. In cases of poor exposition of SM, the access was performed anteriorly to the FN via drilling of the pyramidal eminence (PE). The total access rate of the SM via both the retrofacial and anterior approach of the FN was 100%. In 81.2% of cases (13/16), the retrofacial approach allowed to access the SM on previously categorized well exposed (8/8), partially exposed (4/5), and wholly concealed (1/3) SM with respect to FN. Following intraoperative evaluation in the remaining 18.8% (3/16), the SM was accessed anteriorly via drilling of the PE. Exposure of SM with respect to the FN and the sigmoid sinus’s prominence was a predictor for the suitable surgical approach. The retrofacial approach offers feasible and reproducible access to the SM belly, opening direct access to electromyographic sensing of the eSRT. Surgical planner tools can quantitatively assist pre-surgical assessment.
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Affiliation(s)
| | - Dirk Arnold
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Daniela Korth
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Rene Aschenbach
- Department of Radiology, Jena University Hospital, Jena, Germany
| | - Johann-Martin Hempel
- Department of Neuroradiology, University of Tübingen Medical Center, Tübingen, Germany
| | - Fritz Schneider
- Department of Otolaryngology-Head & Neck Surgery, Hearing Research Center, University of Tübingen Medical Center, Tübingen, Germany
| | - Thore Schade-Mann
- Department of Otolaryngology-Head & Neck Surgery, Hearing Research Center, University of Tübingen Medical Center, Tübingen, Germany
| | - Philipp Gamerdinger
- Department of Otolaryngology-Head & Neck Surgery, Hearing Research Center, University of Tübingen Medical Center, Tübingen, Germany
| | - Anke Tropitzsch
- Department of Otolaryngology-Head & Neck Surgery, Hearing Research Center, University of Tübingen Medical Center, Tübingen, Germany
| | - Hubert Löwenheim
- Department of Otolaryngology-Head & Neck Surgery, Hearing Research Center, University of Tübingen Medical Center, Tübingen, Germany
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5
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Palani S, Alexander A, Sreenivasan A. Evaluation of the Electrically-Evoked Stapedial Reflex Threshold in Pediatric Cochlear Implant Users with High-Frequency Probe Tones. Int Arch Otorhinolaryngol 2022; 26:e566-e573. [DOI: 10.1055/s-0042-1742332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 10/17/2021] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction Measurement of the electrically-evoked stapedial reflex threshold (ESRT) is an objective tool used to set the comfort levels in pediatric cochlear implant (PCI) users. The levels of ESRT have a strong correlation with comfort levels. However, the clinical utility of ESRT is limited because the ESRT response is not observed in all cochlear implant users.
Objective To assess the effects of probe-tone frequency on ESRT and its relationship with the behavioral comfort levels in PCI users.
Methods A total of 14 PCI users aged between 5 and 8 years participated in the study. The ESRT levels were measured using high-frequency probe tones (678 Hz and 1,000 Hz), and the default 226 Hz probe tone. The ESRT was measured with single-electrode stimulation across the three electrode locations (basal [E01]; middle [E11]; and apical [E22]). The ESRT levels measured with different probe tone frequencies were compared with the behavioral comfort levels.
Results The mean ESRT levels using 1,000Hz and 678 Hz were lower than those measured using 226 Hz, but there was no main effect of probe-tone frequency (p > 0.05). A significantly high incidence of successful ESRT measurements occurred with higher-frequency probe tone (p < 0.039). Additionally, ESRT using higher probe tones significantly correlated with comfort levels.
Conclusion The ESRT with higher probe tones was correlated with behavioral comfort levels and increased the success rate of the measurements. Higher-frequency probe tones may be useful whenever ESRT with 226 Hz is not measurable.
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Affiliation(s)
- Saravanan Palani
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Arun Alexander
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Anuprasad Sreenivasan
- Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Cornejo JM, Quintana AK, Beltran NE, Granados P. Measuring implanted patient response to tone pips. Biomed Eng Online 2021; 20:10. [PMID: 33446195 PMCID: PMC7807692 DOI: 10.1186/s12938-020-00844-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022] Open
Abstract
Background An electrical potential not previously reported—electrical cochlear response (ECR)—observed only in implanted patients is described. Its amplitude and growth slope are a measurement of the stimulation achieved by a tone pip on the auditory nerve. The stimulation and recording system constructed for this purpose, the features of this potential obtained in a group of 43 children, and its possible clinical use are described. The ECR is obtained by averaging the EEG epochs acquired each time the cochlear implant (CI) processes a tone pip of known frequency and intensity when the patient is sleeping and using the CI in everyday mode. The ECR is sensitive to tone pip intensity level, microphone sensitivity, sound processor gain, dynamic range of electrical current, and responsiveness to electrical current of the auditory nerve portion involved with the electrode under test. It allows individual evaluation of intracochlear electrodes by choosing, one at the time, the central frequency of the electrode as the test tone pip frequency, so the ECR measurement due to a variable intensity tone pip allows to establish the suitability of the dynamic range of the electrode current. Results There is a difference in ECR measurements when patients are grouped based on their auditory behavior. The ECR slope and amplitude for the Sensitive group is 0.2 μV/dBHL and 10 μV at 50 dBHL compared with 0.04 μV/dBHL and 3 μV at 50dBHL for the Inconsistent group. The clinical cases show that adjusting the dynamic range of current based on the ECR improved the patient’s auditory behavior. Conclusions ECR can be recorded regardless of the artifact due to the electromyographic activity of the patient and the functioning of the CI. Its amplitude and growth slope versus the intensity of the stimulus differs between electrodes. The relationship between minimum ECR detection intensity level and auditory threshold suggests the possibility of estimating patient auditory thresholds this way. ECR does not depend on the subject’s age, cooperation, or health status. It can be obtained at any time after implant surgery and the test procedure is the same regardless of device manufacturer.
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Affiliation(s)
- Juan M Cornejo
- Electrical Engineering Department, Biomedical Engineering Area, Metropolitan Autonomous University, Av. San Rafael Atlixco 186, Leyes de Reforma 1ra Secc, 09340, Iztapalapa, CDMX, Mexico.
| | - Agar K Quintana
- Gratuate Program in Biomedical Engineering, Metropolitan Autonomous University, Av. San Rafael Atlixco 186, Leyes de Reforma 1Ra Secc, 09340, Iztapalapa, CDMX, Mexico
| | - Nohra E Beltran
- Process and Technology Department, Metropolitan Autonomous University, Vasco de Quiroga 4871, 05348, Cuajimalpa de Morelos, CDMX, Mexico.
| | - Pilar Granados
- Electrical Engineering Department, Biomedical Engineering Area, Metropolitan Autonomous University, Av. San Rafael Atlixco 186, Leyes de Reforma 1ra Secc, 09340, Iztapalapa, CDMX, Mexico
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7
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Purcell PL, Deep NL, Waltzman SB, Roland JT, Cushing SL, Papsin BC, Gordon KA. Cochlear Implantation in Infants: Why and How. Trends Hear 2021; 25:23312165211031751. [PMID: 34281434 PMCID: PMC8295935 DOI: 10.1177/23312165211031751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.
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Affiliation(s)
- Patricia L. Purcell
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas L. Deep
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Susan B. Waltzman
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - J. Thomas Roland
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Sharon L. Cushing
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Çiprut A, Adıgül Ç. The Relationship between Electrical Stapedius Reflex Thresholds and Behaviorally Most Comfortable Levels in Experienced Cochlear Implant Users. J Int Adv Otol 2020; 16:8-12. [PMID: 31287433 PMCID: PMC7224436 DOI: 10.5152/iao.2019.6589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Programming the cochlear implant's speech processor with subjective methods in young, uncooperative children is difficult. Since young children cannot provide adequate feedback to the clinician, objective methods which do not require patient's response were often used. Electrical Stapedius Reflex Test is one of the most common procedures used. The goal of this study was to investigate the relationship between electricalstapedius reflex thresholds and behaviorally most comfortable levels in experienced cochlear implant users. MATERIALS AND METHODS The patients implanted with two brands of cochlear implants were compared in terms of electrical stapedius reflex thresholds versus most comfortable levels. Speech tests results were also compared between the two groups. 46 cochlear implanted patients who had at least 1 year of cochlear implant experience were included in the study. 28 patients were implanted with Nucleus, 18 patients with Med-El devices. RESULTS Moderate correlations were obtained between Electrical Stapedius Reflex (ESR) thresholds and C levels in Nucleus users; higher correlations were obtained for Med-El patients. ESR thresholds were present at higher levels than MCL/C levels in both Nucleus and Med-El users. No significant difference was obtained between the two groups in terms of speech tests. CONCLUSION ESR test can be very informative for programming young and uncooperative patients.
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Affiliation(s)
- Ayça Çiprut
- Department of Audiology, Marmara University School of Medicine, İstanbul, Turkey
| | - Çağlayan Adıgül
- Department of Audiology, Sakarya University School of Health, Sakarya, Turkey
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Chugunova TI, Zherenkova VV, Goyhburg MV, Potalova LA, Mosin VV, Bakhshinyan VV, Tavartkiladze GA. [Evoked potentials in the rehabilitation of the patients after cochlear implantation]. Vestn Otorinolaringol 2018; 83:21-25. [PMID: 30113575 DOI: 10.17116/otorino201883421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective methods for the hearing examination of the patients after cochlear implantation provide an important tool for the speech processor fitting. The aim of the present study was to evaluate the possibilities and the informative value of the electrically evoked compound action potential (ECAP) and electrically evoked auditory brainstem response (EABR) combined recording technique. For this reason, the comparison of the ECAP and EABR thresholds with comfortable levels of stimulation, obtained on the basis of subjective response and psychophysical testing of the patients with good results after cochlear implantation was performed. 19 patients with the CI experience from 1 to 5 years were included in our study. The combined registration of ECAP and EABR can be used to evaluate the functional capacity of the central auditory pathways and for the fitting of the complicated patients, especially those in whom the registration proved impossible with the use of other objective techniques. The ECAP and EABR threshold values were well correlated with the individual stimulation map profiles in the patients with the CI experience of less than two years (p<0.05). The results obtained in the present study allow us to conclude that combined registration of ECAP and EABR could be used for the determination of stimulation comfort level parameters and individual stimulation map profiles, especially in combination with the minimum amount of psychoacoustic information received from the patient.
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Affiliation(s)
- T I Chugunova
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - V V Zherenkova
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - M V Goyhburg
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - L A Potalova
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - V V Mosin
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - V V Bakhshinyan
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
| | - G A Tavartkiladze
- Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513
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10
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Use of Electrically Evoked Compound Action Potentials for Cochlear Implant Fitting: A Systematic Review. Ear Hear 2018; 39:401-411. [DOI: 10.1097/aud.0000000000000495] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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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.
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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
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12
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Incerti PV, Ching TYC, Hou S, Van Buynder P, Flynn C, Cowan R. Programming characteristics of cochlear implants in children: effects of aetiology and age at implantation. Int J Audiol 2017; 57:S27-S40. [PMID: 28885072 DOI: 10.1080/14992027.2017.1370139] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We investigated effects of aetiology and age at implantation on changes in threshold (T) levels, comfortable (C) levels and dynamic range (DR) for cochlear implants (CIs) in children over the first five years of life. DESIGN Information was collected at 6 months post-activation of CIs, and at 3 and 5 years of age. STUDY SAMPLE One hundred and sixty-one children participating in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. RESULTS Children with neural and structural cochlear lesions had higher T-levels and C-levels as compared to those without these conditions. Parameter settings varied from manufacturer's defaults more often in the former than in the latter group. Investigation of the effect of age at implantation for children without neural and structural cochlear lesions showed that those implanted at ≤12 months of age had higher T-levels and narrower DR at 6 months post-activation, as compared to the later-implanted group. For both early- and later-implanted groups, the C-levels at 6 months post-activation were lower than those at age 3 and 5 years. There were no significant differences in T-levels, C-levels, or DR between age 3 and 5 years. CONCLUSIONS Aetiology and age at implantation had significant effects on T-levels and C-levels.
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Affiliation(s)
- Paola V Incerti
- a National Acoustic Laboratories, Australian Hearing Hub, Macquarie University , Sydney , Australia.,b The Hearing CRC , Melbourne , Australia ; and.,c The University of Melbourne , Melbourne , Australia
| | - Teresa Y C Ching
- a National Acoustic Laboratories, Australian Hearing Hub, Macquarie University , Sydney , Australia.,b The Hearing CRC , Melbourne , Australia ; and
| | - Sanna Hou
- a National Acoustic Laboratories, Australian Hearing Hub, Macquarie University , Sydney , Australia.,b The Hearing CRC , Melbourne , Australia ; and
| | - Patricia Van Buynder
- a National Acoustic Laboratories, Australian Hearing Hub, Macquarie University , Sydney , Australia.,b The Hearing CRC , Melbourne , Australia ; and
| | - Christopher Flynn
- a National Acoustic Laboratories, Australian Hearing Hub, Macquarie University , Sydney , Australia
| | - Robert Cowan
- b The Hearing CRC , Melbourne , Australia ; and.,c The University of Melbourne , Melbourne , Australia
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Stimulation parameters differ between current anti-modiolar and peri-modiolar electrode arrays implanted within the same child. The Journal of Laryngology & Otology 2016; 130:1007-1021. [PMID: 27739380 DOI: 10.1017/s0022215116009026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare stimulation parameters of peri-modiolar and anti-modiolar electrode arrays using two surgical approaches. METHODS Impedance, stimulation thresholds, comfortably loud current levels, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds were compared between 2 arrays implanted in the same child at 5 time points: surgery, activation/day 1, week 1, and months 1 and 3. The peri-modiolar array was implanted via cochleostomy in all children (n = 64), while the anti-modiolar array was inserted via a cochleostomy in 43 children and via the round window in 21 children. RESULTS The anti-modiolar array had significantly lower impedance, but required higher current levels to elicit thresholds, comfort, electrically evoked compound action potential thresholds and electrically evoked stapedial reflex thresholds than the peri-modiolar array across all time points, particularly in basal electrodes (p < 0.05). The prevalence of open electrodes was similar in anti-modiolar (n = 5) and peri-modiolar (n = 3) arrays. CONCLUSION Significant but clinically acceptable differences in stimulation parameters between peri-modiolar and anti-modiolar arrays persisted four months after surgery in children using bilateral cochlear implants. The surgical approach used to insert the anti-modiolar array had no overall effect on outcomes.
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