Department Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Otol Neurotol. 2010 Feb;31(2):204-9. doi: 10.1097/MAO.0b013e3181ca8457.
To determine whether packing of the cochleostomy site influences electrically evoked compound action potential (ECAP) thresholds.
Prospective nonrandomized control study.
Tertiary referral pediatric hospital.
Eleven consecutive children who received unilateral or bilateral cochlear implants (16 Nucleus 24RE Freedom precurved advanced off-stylet electrode arrays [Cochlear Corp., Lane Cove, New South Wales, Australia]) between June and September 2008.
Electrically evoked compound action potential thresholds were evoked by stimulation of basal (electrode 3), mid (electrode 9), and apical (electrode 20) electrodes during cochlear implant surgery in the operating room. The first recording was completed immediately after insertion of the electrode array before cochleostomy packing, and the same measures were collected immediately after the packing. The time between recordings was 5 minutes.
Electrically evoked compound action potential thresholds evoked by the apical electrode did not significantly change from pre- to post-cochleostomy packing, but ECAP thresholds increased significantly after packing when evoked by the mid-array electrode (mean, +10 clinical units; p < 0.001) and decreased significantly when evoked by the basal electrode (mean, -5.6 clinical units; p = 0.023). These changes were unrelated to passive changes occurring over the first 5 minutes after insertion of the electrode array.
Packing of the cochleostomy causes changes in ECAP thresholds evoked by mid and basal areas of the implant electrode array. These findings suggest that packing shifts the electrode array in the cochlea, increasing the distance from the modiolus in the mid array and decreasing this distance at the basal end. This study is concerned with a single electrode array from a single manufacturer and a single insertion method (precurved off-stylet electrode). These conclusions may be too broad to apply to all precurved electrode arrays.
确定鼓室造口部位的填塞是否会影响电诱发复合动作电位（ECAP）阈值。
前瞻性非随机对照研究。
三级转诊儿科医院。
2008 年 6 月至 9 月期间连续接受单侧或双侧耳蜗植入（16 个 Nucleus 24RE Freedom 预弯高级外鞘电极阵列[ Cochlear Corp.，Lane Cove，新南威尔士，澳大利亚]）的 11 名连续儿童。
在手术室中，通过刺激基底（电极 3）、中部（电极 9）和顶部（电极 20）电极来诱发电诱发复合动作电位阈值。第一次记录是在插入电极阵列后立即完成的，即在鼓室造口填塞之前，并且在填塞后立即采集相同的测量值。两次记录之间的时间为 5 分钟。
顶部电极诱发的 ECAP 阈值在鼓室造口填塞前后没有显著变化，但在填塞后，中部电极（平均增加 10 个临床单位；p<0.001）和基底电极（平均减少 5.6 个临床单位；p=0.023）诱发的 ECAP 阈值显著增加。这些变化与插入电极阵列后的前 5 分钟内发生的被动变化无关。
鼓室造口填塞会导致植入电极阵列中部和基底区域的 ECAP 阈值发生变化。这些发现表明，填塞会使电极阵列在耳蜗内移位，增加中部电极与蜗轴的距离，同时减少基底端的距离。本研究涉及单个制造商的单个电极阵列和单一插入方法（预弯外鞘电极）。这些结论可能过于广泛，无法应用于所有预弯电极阵列。
