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Apical Reference Stimulation: A Possible Solution to Facial Nerve Stimulation.

Jacques van der Westhuizen¹, Tania Hanekom, Johan J Hanekom

¹Bioengineering, Department of Electrical, Electronic and Computer Engineering, University of Pretoria, Pretoria, Gauteng, South Africa.

Ear and Hearing

|December 19, 2021

Summary

This summary is machine-generated.

Apical reference stimulation effectively reduces facial nerve stimulation in cochlear implant users. This method improves auditory thresholds and dynamic range, offering a viable solution for managing this common side effect.

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Area of Science:

Otolaryngology
Biomedical Engineering
Neuroscience

Background:

Facial nerve stimulation (FNS) is a frequent complication of intracochlear electrical stimulation during cochlear implantation.
Current management strategies for FNS, such as speech processor adjustments, may offer limited efficacy or negatively impact speech perception.

Purpose of the Study:

To investigate the potential of apical reference stimulation as an intervention to mitigate FNS.
To evaluate the effectiveness of apical reference stimulation in reducing FNS and its impact on auditory perception.

Main Methods:

Development of a personalized computational model of the cochlea, facial nerve, and electrode array.
Utilizing neural modeling to predict auditory and facial nerve fiber excitation.
Conducting psychoacoustic tests to assess auditory comfort and threshold levels with apical reference stimulation.
Recording electromyography (EMG) data in two participants to quantify facial nerve activity.

Main Results:

Computational models predicted higher facial nerve fiber thresholds and lower auditory thresholds with apical reference stimulation compared to monopolar stimulation.
Psychoacoustic tests demonstrated reduced auditory thresholds and an expanded dynamic range with apical reference stimulation.
Apical reference stimulation led to decreased EMG energy levels, indicating reduced FNS.
Subjective reports confirmed alleviation of FNS symptoms with apical reference stimulation.

Conclusions:

Apical reference stimulation presents a promising strategy for managing FNS in cochlear implant recipients.
Improvements in dynamic range and auditory thresholds, coupled with reduced FNS, support the viability of this stimulation mode.