Article
Increasing the reliability of real-time electrocochleography during cochlear implantation: a standardized guideline
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Published: | September 12, 2022 |
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Outline
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Objective: Electrocochleography (ECochG) measures electrical potentials generated by the inner ear in response to acoustic stimulation. Real-time (rt) recordings are increasingly used during cochlear implant (CI) surgeries to monitor the inner ear function. However, performing rt-ECochG is a delicate measurement procedure involving several pitfalls, which lead to inaccurate or invalid signal recordings in up to 20%. In order to use the technique routinely in CI candidates, we must achieve an improvement in measurement reliability.
Design: In our prospective study, we systematically investigated potential pitfalls and error sources during rt-ECochG recordings. We performed experiments i) on a head and torso simulator, ii) on a whole-head cadaver specimen, iii) as well as in vivo during rt-ECochG recordings in CI recipients. After analysing experiments i-iii, we developed a standardized measurement procedure. We followed this guideline in 10 CI recipients to test the measurement reliability.
Results: Besides improper installation, surgical and patient-specific factors influenced the measured signal. In particular, the unattenuated presentation of the acoustic stimulus was of importance. We summarized our findings in a standardized guideline. Following this guideline, we measured successful intraoperative ECochG recordings in 9/10 patients.
Conclusions: Our error analysis improved the understanding of successful rt-ECochG measurements. When following our proposed guideline, we achieved more reliable intraoperative ECochG recordings.