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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
EABR measurements during cochlear implantation in one-year-old, infant, child, adult, and elderly patients
Chieko Enomoto1,2, Shujiro Minami1, Kimitaka Kaga3
1Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Insights
Electrically-evoked auditory brainstem responses (eABRs) show no latency changes with age after one year, suggesting brainstem auditory pathways are mature. This finding aids in diagnosing auditory pathway abnormalities across all age groups.
Area of Science:
- Neuroscience
- Audiology
- Biomedical Engineering
Background:
- Clinical application of electrically-evoked intracochlear auditory brainstem responses (eABRs) for evaluating brainstem maturity or aging is under-investigated.
- Understanding developmental and aging effects on the auditory brainstem pathway is crucial for clinical diagnostics.
Purpose of the Study:
- To compare eABR latencies across different age groups (infants, children, adults, elderly) during intraoperative cochlear implantation.
- To investigate developmental and aging-related changes in the brainstem auditory pathway using eABRs.
Main Methods:
- Studied 58 ears from 51 cochlear implant patients (2013-2019) using MED-EL implants and electrodes.
- Recorded intraoperative eABRs with stimuli delivered to apical, middle, and basal turn electrodes at varying levels.
- Analyzed eABR latency differences between age groups at different stimulus intensities.
Main Results:
- No significant difference in eABR latency was observed between age groups at any stimulus level.
- Latency remained consistent across infants, children, adults, and the elderly.
Conclusions:
- Auditory brainstem response (ABR) latency is not affected by development after age one or by aging.
- This study provides normative eABR data, valuable for identifying abnormal wave configurations in cochlear malformations, nerve deficiencies, or auditory neuropathy, irrespective of age.
Background:
Clinical application of electrically-evoked intracochlear auditory brainstem responses (eABRs) for evaluation of brainstem maturity or aging changes has not been well investigated.
Aim/Objective:
We compare the eV latencies of intraoperative eABR measurements in one-year-olds, infants, children, adults, and the elderly, with the goal of investigating the changes in the brainstem auditory pathway due to development and aging.
Materials And Methods:
We studied 58 ears of 51 patients who underwent cochlear implantation between 2013 and 2019 using MED-EL's Concerto or Synchrony implants with Flex28 or Flex soft electrodes. EABRs were recorded during cochlear implantation. The stimuli were delivered by the MED-EL Maestro to the apical, middle, and basal turn electrodes at stimulus levels 1000, 800, and 600 cu, with a pulse width of 30 µs.
Results:
In eABRs recorded from electrodes installed at both the mastoid and nape, there was no difference in latency between age groups within each stimulus level.
Conclusion And Significance:
ABR latency was not affected by development after age one and aging of the brainstem auditory pathway. Our study will be useful as a control in identifying abnormal eABR wave configurations in patients with cochlear malformations, cochlear nerve deficiencies, or auditory neuropathy, regardless of age.
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