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Objective intraoperative method to record averaged electromyographic stapedius muscle reflexes in cochlear implant
B Almqvist1, S Harris, J K Shallop
1Department of Otorhinolaryngology, University Hospital, Lund, Sweden.
Insights
We developed a method to measure averaged stapedius muscle reflex in response to electrical stimulation (AESR) using cochlear implants. This technique helps assess stapedius muscle responses, aiding in programming cochlear implants for young children.
Area of Science:
- Audiology
- Neurosurgery
- Biomedical Engineering
Background:
- Cochlear implants are crucial for hearing restoration in children.
- Assessing implant function in young children can be challenging.
- The stapedius muscle reflex provides objective feedback on auditory pathway integrity.
Purpose of the Study:
- To develop and evaluate a novel intra-operative method for measuring the averaged stapedius muscle reflex in response to electrical stimulation (AESR) in children with cochlear implants.
- To assess the feasibility and consistency of AESR measurements.
- To explore the potential utility of AESR in optimizing cochlear implant programming.
Main Methods:
- Developed a procedure to measure AESR during intra-operative cochlear implantation.
- Used electromyographic (EMG) needle electrodes placed in the stapedius muscle.
- Monitored stapedius reflex visually (VESR) and as averaged EMG response (AESR) during ipsilateral cochlear implant stimulation.
- Collected comparative post-operative measures including behavioral thresholds and contralateral stapedius reflex thresholds (ESR).
Main Results:
- Consistent AESRs were obtained in 7 out of 12 pediatric patients.
- The AESR method provided objective measurements of stapedius muscle response.
- Feasibility of intra-operative AESR measurement was demonstrated.
Conclusions:
- The developed AESR procedure offers a viable method for assessing stapedius muscle responses in pediatric cochlear implant recipients.
- AESR measurements may assist in the programming and fitting of cochlear implants in young children.
- This technique provides valuable intra-operative data for auditory pathway assessment.
Abstract:
We have developed a procedure to measure the averaged stapedius muscle reflex in response to electrical stimulation (AESR) with a cochlear implant. The AESR, as activated by ipsilateral stimulation with a cochlear implant, was investigated intra-operatively in a series of 12 children. After the cochlear implant was placed into the cochlea and secured by the surgeon, an electromyographic (EMG) needle electrode was gently placed into the stapedius muscle. During stimulation of the cochlear implant, the stapedius reflex was monitored visually (VESR) and as an averaged EMG response (AESR). Consistent AESRs were obtained in 7 of the 12 children. These measures provide a method to obtain stapedius muscle responses that may be helpful in the programming of young children with cochlear implants. Comparative post-operative measures were also obtained, including behavioral threshold levels, behavioral comfort levels, and the contralateral stapedius reflex threshold (ESR) on selected electrodes.