K Schuerch1,2, M Waser2, G Mantokoudis2, L Anschuetz2, M Caversaccio1,2, W Wimmer1,2, S Weder3. 1. Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland. 2. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland. 3. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland. stefan.weder@insel.ch.
Abstract
PURPOSE: 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, the performance of 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, an improvement in measurement reliability must be achieved. METHODS: 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 analyzing experiments i-iii, a standardized measurement procedure was developed. 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.
PURPOSE: 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, the performance of 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, an improvement in measurement reliability must be achieved. METHODS: 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 analyzing experiments i-iii, a standardized measurement procedure was developed. 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.
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