Hiroshi Yamazaki1, Jaime Leigh, Robert Briggs, Yasushi Naito. 1. *Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan; †Institute of Biomedical Research and Innovation, Kobe, Japan; ‡Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; §Departments of Audiology and Speech Pathology and ||Otolaryngology, The University of Melbourne, Parkville, Australia; and ¶The HEARing CRC, Melbourne, Australia.
Abstract
OBJECTIVE: Cochlear nerve deficiency (CND) is often associated with poor cochlear implant (CI) outcomes, and patients with CND may be candidates for auditory brainstem implantation (ABI). The purpose of this study was to identify investigations which predict CI outcomes immediately after cochlear implantation to recommend ABI within the critical period of auditory development when cochlear implantation precedes ABI. STUDY DESIGN: Retrospective case review. SETTING: Cochlear implant centers at tertiary referral hospitals. PATIENTS: Nineteen children with CND who underwent cochlear implantation and intraoperative electrically evoked auditory brainstem response (EABR) testing. INTERVENTIONS: Diagnostic and therapeutic. MAIN OUTCOME MEASURES: Preoperative MRI and intraoperative EABR were used to evaluate relative diameter of the vestibulocochlear nerve (CN8) compared to the facial nerve (CN7) at the cerebellopontine angle and presence of evoked wave Vs (eVs) with typical latency, respectively. Correlation between 2-year postoperative categories of auditory performance (CAP) scores and results of MRI and EABR were evaluated. RESULTS: Each classification using MRI or EABR was significantly associated with the CI outcomes. Combination of the MRI and EABR results allowed better discrimination between poor CI users and moderate to good CI users than either examination used separately. All children in "CN7 > CN8/negative eV" showed ≤3, while all in "CN7 ≤ CN8/positive eV" achieved ≥3 in the postoperative CAP score. CONCLUSIONS: Combination of MRI and EABR results allows prediction of CI outcomes immediately after cochlear implantation. This should facilitate management decision making for auditory implantation in children with CND.
OBJECTIVE:Cochlear nerve deficiency (CND) is often associated with poor cochlear implant (CI) outcomes, and patients with CND may be candidates for auditory brainstem implantation (ABI). The purpose of this study was to identify investigations which predict CI outcomes immediately after cochlear implantation to recommend ABI within the critical period of auditory development when cochlear implantation precedes ABI. STUDY DESIGN: Retrospective case review. SETTING: Cochlear implant centers at tertiary referral hospitals. PATIENTS: Nineteen children with CND who underwent cochlear implantation and intraoperative electrically evoked auditory brainstem response (EABR) testing. INTERVENTIONS: Diagnostic and therapeutic. MAIN OUTCOME MEASURES: Preoperative MRI and intraoperative EABR were used to evaluate relative diameter of the vestibulocochlear nerve (CN8) compared to the facial nerve (CN7) at the cerebellopontine angle and presence of evoked wave Vs (eVs) with typical latency, respectively. Correlation between 2-year postoperative categories of auditory performance (CAP) scores and results of MRI and EABR were evaluated. RESULTS: Each classification using MRI or EABR was significantly associated with the CI outcomes. Combination of the MRI and EABR results allowed better discrimination between poor CI users and moderate to good CI users than either examination used separately. All children in "CN7 > CN8/negative eV" showed ≤3, while all in "CN7 ≤ CN8/positive eV" achieved ≥3 in the postoperative CAP score. CONCLUSIONS: Combination of MRI and EABR results allows prediction of CI outcomes immediately after cochlear implantation. This should facilitate management decision making for auditory implantation in children with CND.
Authors: Laurel M Fisher; Amy S Martinez; Frances J Richmond; Mark D Krieger; Eric P Wilkinson; Laurie S Eisenberg Journal: Ther Innov Regul Sci Date: 2017-11-29 Impact factor: 1.778
Authors: Shuman He; Tyler C McFayden; Bahar S Shahsavarani; Holly F B Teagle; Matthew Ewend; Lillian Henderson; Craig A Buchman Journal: Ear Hear Date: 2018 May/Jun Impact factor: 3.562