Page Joshua Cody, Murphy Linda, Kennett Sarah, Trinidade Aaron, Frank Robert, Cox Matthew, Dornhoffer John L
University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Otol Neurotol. 2017 Sep;38(8):1092-1096. doi: 10.1097/MAO.0000000000001489.
To review our use of intraoperative testing during cochlear implantation (CI) and determine its impact on surgical decision-making.
Retrospective chart review.
Tertiary referral center.
A total of 197 children and adults who underwent a total of 266 primary and/or revision CI by a single surgeon from 2010 to 2015.
Intraoperative electrophysiologic monitoring including evoked compound action potentials and electrical impedances.
Whether surgical management was changed based on intraoperative testing.
In only 2 of 266 patients (0.8%), the back-up device was used due to findings on intraoperative testing. In three patients (1.1%), X-ray was performed intraoperatively to confirm intracochlear electrode placement, which was found to be normal in all patients.
Our data suggest that with respect to CI in children and adults in straightforward cases (e.g., normal anatomy, nondifficult insertion, etc.), routine intraoperative evoked compound action potentials, impedances, and imaging rarely influence surgical decision-making in our clinic and may have limited usefulness in these patients. The implications of this are discussed and a review of the literature is presented.
回顾我们在人工耳蜗植入（CI）术中测试的应用情况，并确定其对手术决策的影响。
回顾性病历审查。
三级转诊中心。
2010年至2015年期间，共有197名儿童和成人接受了同一位外科医生进行的总共266次初次和/或翻修CI手术。
术中电生理监测，包括诱发复合动作电位和电阻抗。
手术管理是否根据术中测试结果进行改变。
在266例患者中，仅2例（0.8%）因术中测试结果而使用了备用设备。3例患者（1.1%）术中进行了X线检查以确认人工耳蜗电极在耳蜗内的位置，所有患者的检查结果均正常。
我们的数据表明，对于儿童和成人的简单CI病例（例如，解剖结构正常、插入无困难等），常规的术中诱发复合动作电位、电阻抗和成像在我们的诊所很少影响手术决策，对这些患者的作用可能有限。本文讨论了其影响并对相关文献进行了综述。
