SPECT evaluation of regional cerebral activation during electrical auditory stimulation in profoundly deal patients

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Electrical promontory stimulation test has been used for preoperative functional evaluation of the auditory nerve in cochlear implant candidates. However, due to the lack of an objective information on cortical integration, results of this test do not seem to predict what extent the cochlear implant will be successful.An attempt was made to employ the single photon emission computed tomography (SPECT) to evaluate a possible change in the regional cerebral blood flow (rCBF) in the central auditory areas during electrical stimulation. A statistically significant increase in rCBF was detected in the temporal lobe in profoundly deaf adult patients. Discrepancy between subjective auditory sensation and rCBF changes in response to electrical stimulation may limit the potential usefulness of SPECT in preoperative evaluation of the cortical integration in cochlear implant candidates. However a significant activation of the auditory cortex detected in 2 cases with central nerve diseases encouraged both patients and surgeons for cochlear implantation. Further studies including pre- and postoperative tests using rCBF SPECT should be helpful to determine the mechanism of sound integration in profoundly deaf patients involving central auditory pathways.