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Author Spotlight: Advancements in Impedance Monitoring for Cochlear Implant Surgery
Published on: August 4, 2023
The relationship between intraoperative and postoperative Neural Response Thresholds (NRT) and postoperative auditory
Reza Jahangiri1, Pardis Abtahian2, Seyed Basir Hashemi1
1Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
One of the important factors in evaluating the effectiveness of cochlear implants in children is the level of neural response thresholds (NRT). This study aims to assess and compare intraoperative and postoperative NRT concerning their ability to predict postoperative speech perception in cochlear implant patients.
Methods:
In this observational study, two groups of cochlear implant recipients who underwent surgery between April 2011-March 2022 and met the inclusion criteria were selected using purposive sampling. Intra- and postoperative neural response telemetry (NRT) data were collected, along with postoperative outcomes from the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) questionnaires, administered at six and nine months after implantation. One group consisted of patients with negative intraoperative NRT, while the other included patients with positive intraoperative NRT. Comparisons between groups were performed, data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, Illinois, USA) version 22.0.
Results:
There was a significant improvement in NRT values following surgery. Additionally, intra- and postoperative thresholds showed a significant correlation. Both CAP and SIR scores also improved significantly during follow-up. Postoperative NRT significantly correlated with CAP and SIR scores after six and nine months, whereas intraoperative NRT did not demonstrate this correlation. Nonetheless, the feasibility of measuring intraoperative NRT significantly indicated better future speech perception.
Discussion:
Postoperative NRT may serve as an indicator of the trajectory of auditory functioning in CI patients. However, there remains uncertainty regarding the correlation between intraoperative NRT and outcomes. It sems that the inability to measure intraoperative NRT is associated with poorer speech perception outcomes.
