Kumari Abha, Sahoo Lokanath, Patnaik Uma, Sahoo Krushnendu Sundar, Rao Npc, Kumar Manoj, Thakur Shivali
Department of ENT, CHSC, AFMC, Pune, India.
Department of ENT, AFMC, Pune, India.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):336-342. doi: 10.1007/s12070-022-03284-x. Epub 2023 Jan 9.
This study is designed to compare the Intra Operative Neural Response Telemetry (NRT) results with Post-Operative NRT results of the cochlear implanted children, to assess the importance of Intra Operative NRT thresholds in device activation and/or switch on of the audio processor and to evaluate the importance of Intra and post operative AutoNRT results in predicting behavioural thresholds during mapping of prelingual Cochlear Implanted children.
A total of thirty (30) children (16 boys, 14 girls) with congenital Bilateral (B/L) severe to profound Sensorineural hearing loss (SNHL) were included in this study. Children between the age range of 12 to 60 months were participated in this study. All the participants were implanted with Nucleus 24 cochlear implant system. In each patient, the intra operative NRT-thresholds were measured for all 22 active electrodes. Then Intra Operative NRT thresholds were correlated with Post-Operative NRT thresholds at the time of switch on and the behavioural map after six months of switch on of the device (Audio Processor).
There is a significant enhancement observed in thresholds of postoperative NRT responses which were raised or absent during intraoperative session. There is a gain in NRT thresholds marked after 6 months of postoperative follow up in comparison with first measurement at the time of Switch On of the device but the change not that significant. During postoperative mapping, there was a significant positive correlation noticed between neural response telemetry level measurements and behavioural threshold level.
Absent or elevated NRT responses during intraoperative testing for some electrodes especially basal electrodes does not mean that electrode is out of order or outside the cochlea, because an improvement in NRT thresholds usually occurs postoperatively. In case of children with congenital B/L severe to profound SNHL, the NRT values have a very useful role in predicting the behavioural thresholds. Combination of NRT values with behavioural thresholds and observations of Auditory Verbal Therapist can help in providing best suitable Map to the recipient.
The online version contains supplementary material available at 10.1007/s12070-022-03284-x.
本研究旨在比较人工耳蜗植入儿童的术中神经反应遥测（NRT）结果与术后NRT结果，评估术中NRT阈值在设备激活和/或音频处理器开启中的重要性，并评估术中及术后自动NRT结果在预测语前人工耳蜗植入儿童调图期间行为阈值方面的重要性。
本研究共纳入30名（16名男孩，14名女孩）患有先天性双侧严重至极重度感音神经性听力损失（SNHL）的儿童。年龄在12至60个月之间的儿童参与了本研究。所有参与者均植入了Nucleus 24人工耳蜗系统。在每位患者中，对所有22个有源电极测量术中NRT阈值。然后将术中NRT阈值与设备（音频处理器）开启时的术后NRT阈值以及开启六个月后的行为调图进行相关性分析。
观察到术后NRT反应阈值有显著提高，这些阈值在术中时升高或不存在。与设备开启时的首次测量相比，术后随访6个月后NRT阈值有明显提高，但变化不显著。在术后调图期间，神经反应遥测水平测量与行为阈值水平之间存在显著正相关。
术中测试时某些电极尤其是基底电极的NRT反应缺失或升高并不意味着电极出现故障或位于耳蜗外，因为NRT阈值通常在术后会有所改善。对于患有先天性双侧严重至极重度SNHL的儿童，NRT值在预测行为阈值方面具有非常有用的作用。将NRT值与行为阈值以及听觉言语治疗师的观察结果相结合，有助于为接受者提供最合适的调图。
在线版本包含可在10.1007/s12070-022-03284-x获取的补充材料。
