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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
PubMed
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.