Hannover Medical School, Department of Otolaryngology, Hannover, Germany.
University of Iowa, Department of Otolaryngology, Iowa City, Iowa.
Otol Neurotol. 2022 Jan 1;43(1):e72-e78. doi: 10.1097/MAO.0000000000003403.
To compare intraoperative intracochlear electrocochleography (ECochG) with hearing preservation outcomes in cochlear implant (CI) subjects.
Intraoperative electrocochleography was performed in adult CI subjects who were recipients of Advanced Bionics' Bionics LLC precurved HiFocus MidScala or straight HiFocus SlimJ electrode arrays. ECochG responses were recorded from the most apical electrode contact during insertion. No changes to the insertions were made due to ECochG monitoring. No information about insertion resistance was collected. ECochG drops were estimated as the change in amplitude from peak (defined as maximum amplitude response) to drop (largest drop) point after the peak during insertion was measured following the peak response. Audiometric thresholds from each subject were obtained before and approximately 1 month after CI surgery. The change in pure tone average for frequencies between 125 Hz and 500 Hz was measured after surgery. No postoperative CT scans were collected as part of this study.
A total of 68 subjects from five surgical centers participated in the study. The study sample included 30 MidScala and 38 SlimJ electrodes implanted by approximately 20 surgeons who contributed to the study. Although a wide range of results were observed, there was a moderate positive correlation (Pearson Correlation coefficient, r = 0.56, p < 0.01) between the size of the ECochG drop and the magnitude of pure tone average change. This trend was present for both the MidScala and SlimJ arrays. The SlimJ and MidScala arrays produced significantly different hearing loss after surgery.
Large ECochG amplitude drops observed during electrode insertion indicated poorer hearing preservation. Although the outcomes were variable, this information may be helpful to guide surgical decision-making when contemplating full electrode insertion and the likelihood of hearing preservation.
比较术中耳蜗内电描记法（ECochG）与保留听力的耳蜗植入（CI）受试者的结果。
对成人 CI 受试者进行术中电描记法，这些受试者是 Advanced Bionics 的 Bionics LLC 预弯高聚焦 MidScala 或直高聚焦 SlimJ 电极阵列的接受者。在插入过程中，从最顶端电极接触记录 ECochG 反应。由于 ECochG 监测，不对插入进行任何更改。未收集有关插入电阻的信息。ECochG 下降估计为插入后峰值（定义为最大幅度响应）至下降（最大下降）点的幅度变化，该点是在插入过程中测量峰值响应之后的点。每位受试者的听力阈值均在 CI 手术后之前和大约 1 个月后获得。手术后测量了 125Hz 和 500Hz 之间的纯音平均频率的变化。作为这项研究的一部分，未收集术后 CT 扫描。
共有来自五个手术中心的 68 名受试者参加了这项研究。研究样本包括 30 个 MidScala 和 38 个 SlimJ 电极，由大约 20 名参与研究的外科医生植入。尽管观察到了广泛的结果，但 ECochG 下降幅度与纯音平均变化幅度之间存在中度正相关（Pearson 相关系数，r=0.56，p<0.01）。这种趋势在 MidScala 和 SlimJ 阵列中均存在。SlimJ 和 MidScala 阵列在手术后产生了明显不同的听力损失。
在电极插入过程中观察到的大 ECochG 幅度下降表明听力保留较差。尽管结果各不相同，但此信息可能有助于指导手术决策，即考虑全电极插入和听力保留的可能性。
