Using the Implant Electrode Array to Conduct Real-time Intraoperative Hearing Monitoring During Pediatric Cochlear Implantation: Preliminary Experiences.

OBJECTIVES: To present the preliminary experiences and findings from a pilot study evaluating a novel technique for monitoring cochlear electrophysiological function during electrode insertion in cochlear implantation surgery. STUDY
DESIGN: Prospective pilot cohort study.
SETTING: Tertiary academic neuro-otology center. PATIENTS: Pediatric patients with residual hearing undergoing hearing preservation cochlear implant surgery. INTERVENTION: Monitoring of intraoperative cochlear microphonics during cochlear implant surgery. MAIN OUTCOME MEASURE: Intraoperative intracochlear microphonic measurement, preservation of these responses postoperatively and preservation of hearing as measured by audiometry.
RESULTS: Intracochlear microphonics could be identified in both patients presented and were preserved during the surgical procedure and postoperatively. The preservation of intracochlear microphonics correlates with preservation of hearing.
CONCLUSION: The novel approach using the electrode array to detect and measure intracochlear microphonics during cochlear implantation surgery shows promise as an instrument to alert the operating surgeon to hair cell damage during electrode insertion. Further refinement of the technique is required to better understand the measurements and correlate these with pre- and postoperative hearing and risk of hearing loss from surgery. Improvements in the software algorithm will reduce the time required for each measurement, leading to the development a more real-time monitoring technique.