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Intraoperative Measured Electrocochleography and Fluoroscopy Video to Detect Cochlea Trauma.
Ralf Greisiger1, Christofer Bester2, Torquil Sørensen1
1Department of Otorhinolaryngology and Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.
Summary
Intraoperative X-ray fluoroscopy and electrocochleography (ECochG) revealed that electrode movements during cochlear implantation correlate with hearing loss. These findings aim to refine surgical techniques for better hearing preservation in cochlear implant recipients.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Cochlear implantation (CI) is increasingly used in patients with residual hearing.
- A significant challenge in CI is the post-operative loss of residual hearing.
- Identifying intraoperative events causing hearing loss is crucial for improving surgical outcomes.
Purpose of the Study:
- To correlate intraoperative electrode movements with cochlear function.
- To investigate the timing of traumatic events during cochlear implantation.
- To reduce the incidence of hearing loss after cochlear implantation.
Main Methods:
- Electrocochleography (ECochG) and real-time X-ray fluoroscopy were used during 21 cochlear implant surgeries.
- Postoperative cone-beam CT scans and audiograms up to 1 year were analyzed.
- Correlation between ECochG responses, electrode position, and hearing preservation was assessed.
Main Results:
- Drops in ECochG response significantly correlated with hearing loss.
- Electrode movement during and after insertion, including sealing and coiling, caused reduced cochlear output.
- In some cases, reduced cochlear function was observed prior to electrode insertion.
Conclusions:
- Combining ECochG, fluoroscopy, and CT imaging can identify causes of hearing loss during CI.
- These insights can guide improvements in cochlear implantation surgical procedures.
- Minimizing intraoperative trauma is key to preserving residual hearing.
