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Electrical stimulation of the auditory system after labyrinthectomy
J L Kemink1, P R Kileny, J K Niparko
1Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor.
The American Journal of Otology
|January 1, 1991
Summary
Labyrinthectomy surgery for vertigo may preserve hearing structures. This study shows the operated ear remains excitable, suggesting potential cochlear implant candidacy for some patients.
Area of Science:
- Otolaryngology
- Neuroscience
- Audiology
Background:
- Labyrinthectomy is a surgical treatment for vertigo with nonserviceable hearing.
- Concerns exist about preserving auditory structures due to cochlear implant potential.
- Recent findings suggest spiral ganglion cell survival post-labyrinthectomy.
Purpose of the Study:
- To investigate the electrical stimulability of the operated ear after labyrinthectomy.
- To assess the auditory periphery's excitability following transmastoid labyrinthectomy.
- To determine if labyrinthectomy patients are candidates for cochlear implant rehabilitation.
Main Methods:
- Intraoperative assessment of electrically evoked middle latency response (MLR) potentials in 10 patients.
- Postoperative transtympanic stimulation in 6 patients (3-15 months).
- Comparison of intraoperative electrophysiologic thresholds with postoperative behavioral thresholds.
Main Results:
- All patients demonstrated an excitable auditory periphery postoperatively.
- Postoperative behavioral thresholds correlated with intraoperative electrophysiologic thresholds.
- Evidence of persistent, excitable auditory neural elements after labyrinthectomy.
Conclusions:
- Labyrinthectomy does not necessarily eliminate auditory neural elements.
- Patients who undergo labyrinthectomy may retain candidacy for cochlear implant rehabilitation.
- The operated auditory periphery remains physiologically responsive after labyrinthectomy.