Eur Arch Otorhinolaryngol. 2022 Jan 20. doi: 10.1007/s00405-021-07204-7. Online ahead of print.
ABSTRACT
PURPOSE: Electrocochleography (ECochG) measures electrical potentials generated by the inner ear in response to acoustic stimulation. Real-time (rt) recordings are increasingly used during cochlear implant (CI) surgeries to monitor the inner ear function. However, the performance of rt-ECochG is a delicate measurement procedure involving several pitfalls, which lead to inaccurate or invalid signal recordings in up to 20%. In order to use the technique routinely in CI candidates, an improvement in measurement reliability must be achieved.
METHODS: In our prospective study, we systematically investigated potential pitfalls and error sources during rt-ECochG recordings. We performed experiments (i) on a head and torso simulator, (ii) on a whole-head cadaver specimen, (iii) as well as in vivo during rt-ECochG recordings in CI reci pients. After analyzing experiments i-iii, a standardized measurement procedure was developed. We followed this guideline in 10 CI recipients to test the measurement reliability.
RESULTS: Besides improper installation, surgical and patient-specific factors influenced the measured signal. In particular, the unattenuated presentation of the acoustic stimulus was of importance. We summarized our findings in a standardized guideline. Following this guideline, we measured successful intraoperative ECochG recordings in 9/10 patients.
CONCLUSIONS: Our error analysis improved the understanding of successful rt-ECochG measurements. When following our proposed guideline, we achieved more reliable intraoperative ECochG recordings.
PMID:35048175 | DOI:10.1007/s00405-021-07204-7
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