Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography
Assessment of Cochlear Trauma During Cochlear Implantation Using Electrocochleography and Cone Beam Computed Tomography
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DOI：
10.1097/mao.0000000000000998
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发表时间：
2016-06-01
影响因子：
2.1
通讯作者：
Pfiffner, Flurin
中科院分区：
文献类型：
--
作者：
Dalbert, Adrian;Huber, Alexander;Pfiffner, Flurin
目的：通过耳蜗电图（ECoG）和锥形束计算机断层扫描（CBCT）评估人工耳蜗植入术中的耳蜗损伤，并将术中耳蜗损伤与术后残余听力损失相关联。方法：在插入耳蜗植入电极阵列之前和之后记录250、500、750和1000 Hz的短纯音和点击刺激的ECoG记录，使用的是脑外记录电极。CBCT在术后6周内进行。术中ECoG记录和CBCT结果的变化与术后纯音听力图中的阈值偏移相关。在3名受试者中，在插入电极阵列后，250、500、750和1000 Hz处的低频ECoG反应降低。这与术后4周没有或只有极少量的残余听力有关。ECoG响应点击刺激存在于六个科目，并显示出减少后，插入的电极阵列中的三个。这与术后纯音听力图中平均听力损失21 dB相关。由于CBCT结果，在一个主题中假设的电极阵列的标量脱位，并与低频ECoG反应的减少和残余hearing.Conclusion的完全丧失相关：听力损失11 dB或完全听力损失，术中出现高频或低频ECoG信号的减少，提示急性耳蜗创伤。
Objective: To assess cochlear trauma during cochlear implantation by electrocochleography (ECoG) and cone beam computed tomography (CBCT) and to correlate intraoperative cochlear trauma with postoperative loss of residual hearing.Methods: ECoG recordings to tone bursts at 250, 500, 750, and 1000 Hz and click stimuli were recorded before and after insertion of the cochlear implant electrode array, using an extracochlear recording electrode. CBCTs were conducted within 6 weeks after surgery. Changes of intraoperative ECoG recordings and CBCT findings were correlated with postoperative threshold shifts in pure-tone audiograms.Results: Fourteen subjects were included. In three subjects a decrease of low-frequency ECoG responses at 250, 500, 750, and 1000 Hz occurred after insertion of the electrode array. This was associated with no or minimal residual hearing 4 weeks after surgery. ECoG responses to click stimuli were present in six subjects and showed a decrease after insertion of the electrode array in three. This was associated with a mean hearing loss of 21 dB in postoperative pure-tone audiograms. Scalar dislocation of the electrode array was assumed in one subject because of CBCT findings and correlated with a decrease of low-frequency ECoG responses and a complete loss of residual hearing.Conclusion: Hearing loss of 11 dB or complete hearing loss, an intraoperative decrease of high-or low-frequency ECoG signals occurs, suggesting acute cochlear trauma.