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Trends in Intraoperative Testing During Cochlear Implantation.

Joshua Cody Page1, Matthew D Cox1, Blake Hollowoa1

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Intraoperative testing during cochlear implantation varies widely among surgeons. While most perform testing, many find it rarely changes management, with reassurance being the primary benefit.

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical Device Technology

Background:

  • Lack of consensus on intraoperative testing during cochlear implantation.
  • Significant variation exists in current surgical practice habits.

Purpose of the Study:

  • To survey otologists/neurotologists on their practice habits for intraoperative testing.
  • To assess the perceived usefulness of intraoperative testing in cochlear implantation.

Main Methods:

  • Cross-sectional survey distributed to 194 practicing Otologists/Neurotologists.
  • Survey questions covered practice setting, electrode use, testing modalities, and opinions on testing.
  • Response rate of 20% (39 surgeons).

Main Results:

  • Electrocorticography (ECAPs) and electrical imaging (EIs) were commonly used together (38%), while 33% performed no testing.
  • 89% reported testing rarely or never changes surgical management.
  • 51% cited surgeon/family reassurance as the main reason for testing.

Conclusions:

  • Intraoperative testing practices and opinions vary significantly among surgeons.
  • Most surgeons utilize testing, but many perceive minimal impact on decision-making.
  • The evolving nature of cochlear implant electrodes may influence the future role of intraoperative testing.