Riggs William J, Dwyer Robert T, Holder Jourdan T, Mattingly Jameson K, Ortmann Amanda, Noble Jack H, Dawant Benoit M, Valenzuela Carla V, O'Connell Brendan P, Harris Michael S, Litvak Leonid M, Koka Kanthaiah, Buchman Craig A, Labadie Robert F, Adunka Oliver F
Department of Otolaryngology - Head and Neck Surgery, The Ohio State University, Columbus, Ohio.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
Otol Neurotol. 2019 Jun;40(5):e503-e510. doi: 10.1097/MAO.0000000000002202.
Electrocochleography (ECochG) recorded during cochlear implant (CI) insertion from the apical electrode in conjunction with postinsertion ECochG can identify electrophysiologic differences that exist between groups with and without a translocation of the array from the scala tympani (ST) into the scala vestibuli (SV).
Translocation of the CI electrode from ST into SV can limit performance postoperatively. ECochG markers of trauma may be able to aid in the ability to detect electrode array-induced trauma/scalar translocation intraoperatively.
Twenty-one adult CI patients were included. Subjects were postoperatively parsed into two groups based on analysis of postoperative imaging: 1) ST (n = 14) insertion; 2) SV (n = 7) insertion, indicating translocation of the electrode. The ECochG response elicited from a 500 Hz acoustic stimulus was recorded from the lead electrode during insertion when the distal electrode marker was at the round window, and was compared to the response recorded from a basal electrode (e13) after complete insertion.
No statistically significant change in mean ECochG magnitude was found in either group between recording intervals. There was a mean loss of preoperative pure-tone average of 52% for the nontranslocation group and 94% for the translocation group.
Intraoperative intracochlear ECochG through the CI array provides a unique opportunity to explore the impact of the CI electrode on the inner ear. Specifically, a translocation of the array from ST to SV does not seem to change the biomechanics of the cochlear region that lies basal to the area of translocation in the acute period.
在人工耳蜗（CI）植入过程中，从顶端电极记录的电耳蜗图（ECochG）与植入后ECochG相结合，能够识别电极阵列从鼓阶（ST）移位至前庭阶（SV）的组与未发生移位的组之间存在的电生理差异。
CI电极从ST移位至SV会限制术后性能。创伤的ECochG标志物可能有助于在术中检测电极阵列引起的创伤/蜗管移位。
纳入21例成年CI患者。根据术后影像学分析，将受试者术后分为两组：1）ST组（n = 14）植入；2）SV组（n = 7）植入，表明电极发生移位。当远端电极标记位于圆窗时，在植入过程中从引导电极记录500Hz声刺激引发的ECochG反应，并与完全植入后从基底电极（e13）记录的反应进行比较。
两组在记录间隔期间平均ECochG幅值均未发现有统计学意义的变化。未移位组术前纯音平均听阈平均下降52%，移位组下降94%。
通过CI阵列进行术中蜗内ECochG为探索CI电极对内耳的影响提供了独特的机会。具体而言，在急性期，电极阵列从ST移位至SV似乎并未改变移位区域基底侧耳蜗区域的生物力学。
