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Performing Intracochlear Electrocochleography During Cochlear Implantation

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Improved Cochlear Implant Performance Estimation Using Tonotopic-Based Electrocochleography.

Amit Walia¹, Matthew A Shew¹, Jordan Varghese¹

¹Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.

JAMA Otolaryngology-- Head & Neck Surgery

|October 19, 2023

Summary

This summary is machine-generated.

Electrocochleography-total response (ECochG-TR) at the best-frequency electrode (BF-ECochG-TR) better predicts cochlear implant speech perception than round window (RW-ECochG-TR). Cognitive capacity also impacts performance in noise.

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Area of Science:

Audiology
Neurosurgery
Otolaryngology

Background:

Cochlear implantation offers significant benefits for postlingual deafness, but auditory outcomes vary.
Electrocochleography (ECochG) is a tool for assessing the cochlear-neural substrate and predicting patient prognosis.

Purpose of the Study:

To determine if ECochG-total response (ECochG-TR) at the best-frequency electrode (BF-ECochG-TR) correlates more strongly with speech perception than ECochG-TR measured at the round window (RW-ECochG-TR).

Main Methods:

A cross-sectional study of 109 postlingual adults undergoing cochlear implantation.
Speech perception was assessed using CNC words and AzBio sentences (quiet and noise) at 6 months.
BF-ECochG-TR and RW-ECochG-TR were measured at multiple frequencies.

Main Results:

BF-ECochG-TR showed a stronger correlation with CNC scores (r=0.74) than RW-ECochG-TR (r=0.67).
BF-ECochG-TR also correlated with AzBio in noise (r=0.42).
Cognitive assessment (MoCA) and BF-ECochG-TR together explained 50% of the variability in AzBio scores in noise.

Conclusions:

BF-ECochG-TR is a stronger predictor of cochlear implant speech perception than RW-ECochG-TR.
Both ECochG measures highlight the importance of the cochlear-neural substrate.
Speech perception in noise relies on both the cochlear-neural substrate and cognitive function.