Cochlear implantation via round window or cochleostomy: Effect on hearing in an animal model

Hod, Roy; Attias, Joseph; Raveh, Eyal; Nageris, Ben I.

doi:10.1002/lary.26033

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…The hearing loss measured in our study spanned several octaves, though conductive hearing loss occurring naturally in humans rarely produces at punctate frequency regions on the audiogram. Others have shown that cochlear implantation can be associated with air-bone gaps (Chole et al 2014; Hod et al 2016; Koka et al 2017) and alterations to immittance measurements (Merchant et al 2020; Scheperle & Hajicek 2019). However, simple attenuation of sound transmission through the middle ear would not be expected to cause the observed shifts in the spatial origins of CAP measurements found in the response area tuning curves of Figure 8.…”

Section: Discussionmentioning

confidence: 99%

A Guinea Pig Model Suggests That Objective Assessment of Acoustic Hearing Preservation in Human Ears With Cochlear Implants Is Confounded by Shifts in the Spatial Origin of Acoustically Evoked Potential Measurements Along the Cochlear Length

Lee,

Hartsock,

Salt

et al. 2024

Ear &Amp; Hearing

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Objectives: Our recent empirical findings have shown that the auditory nerve compound action potential (CAP) evoked by a low-level tone burst originates from a narrow cochlear region tuned to the tone burst frequency. At moderate to high sound levels, the origins shift to the most sensitive audiometric regions rather than the extended high-frequency regions of the cochlear base. This means that measurements evoked from extended high-frequency sound stimuli can shift toward the apex with increasing level. Here we translate this study to understand the spatial origin of acoustically evoked responses from ears that receive cochlear implants, an emerging area of research and clinical practice that is not completely understood. An essential step is to first understand the influence of the cochlear implant in otherwise naive ears. Our objective was to understand how function of the high-frequency cochlear base, which can be excited by the intense low-frequency sounds that are frequently used for objective intra- and postoperative monitoring, can be influenced by the presence of the cochlear implant. Design: We acoustically evoked responses and made measurements with an electrode placed near the guinea pig round window. The cochlear implant was not utilized for either electrical stimulation or recording purposes. With the cochlear implant in situ, CAPs were acoustically evoked from 2 to 16 kHz tone bursts of various levels while utilizing the slow perfusion of a kainic acid solution from the cochlear apex to the cochlear aqueduct in the base, which sequentially reduced neural responses from finely spaced cochlear frequency regions. This cochlear perfusion technique reveals the spatial origin of evoked potential measurements and provides insight on what influence the presence of an implant has on acoustical hearing. Results: Threshold measurements at 3 to 11 kHz were elevated by implantation. In an individual ear, thresholds were elevated and lowered as cochlear implant was respectively inserted and removed, indicative of “conductive hearing loss” induced by the implant. The maximum threshold elevation occurred at most sensitive region of the naive guinea pig ear (33.66 dB at 8 kHz), making 11 kHz the most sensitive region to acoustic sounds for guinea pig ears with cochlear implants. Conversely, the acute implantation did not affect the low-frequency, 500 Hz thresholds and suprathreshold function, as shown by the auditory nerve overlapped waveform. As the sound pressure level of the tone bursts increased, mean data show that the spatial origin of CAPs along the cochlear length shifted toward the most sensitive cochlear region of implanted ears, not the extended high-frequency cochlear regions. However, data from individual ears showed that after implantation, measurements from moderate to high sound pressure levels originate in places that are unique to each ear. Conclusions: Alterations to function of the cochlear base from the in situ cochlear implant may influence objective measurements of implanted ears that are frequently made with intense low-frequency sound stimuli. Our results from guinea pigs advance the interpretation of measurements used to understand how and when residual acoustic hearing is lost in human ears receiving a cochlear implant.

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Section: Discussionmentioning

confidence: 99%

A Guinea Pig Model Suggests That Objective Assessment of Acoustic Hearing Preservation in Human Ears With Cochlear Implants Is Confounded by Shifts in the Spatial Origin of Acoustically Evoked Potential Measurements Along the Cochlear Length

Lee,

Hartsock,

Salt

et al. 2024

Ear &Amp; Hearing

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“…With the observation that ABG may exist after implantation of patients with residual hearing (Chole et al, 2014; Raveh et al, 2014; Mattingly et al, 2016) and in normal-hearing animals after implantation (Hod et al, 2016), this ECochG method can provide an objective tool to estimate reliable ABG without technical issues of measuring behavioral BC thresholds in CI subjects. The fact that this group of subjects had ABG in the presence of normal tympanometry suggests that the ABG originated in the inner ear rather than the middle ear.…”

Section: Discussionmentioning

confidence: 99%

An Objective Estimation of Air-Bone-Gap in Cochlear Implant Recipients with Residual Hearing Using Electrocochleography

Koka¹,

Saoji²,

Attias

et al. 2017

Front. Neurosci.

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Although, cochlear implants (CI) traditionally have been used to treat individuals with bilateral profound sensorineural hearing loss, a recent trend is to implant individuals with residual low-frequency hearing. Notably, many of these individuals demonstrate an air-bone gap (ABG) in low-frequency, pure-tone thresholds following implantation. An ABG is the difference between audiometric thresholds measured using air conduction (AC) and bone conduction (BC) stimulation. Although, behavioral AC thresholds are straightforward to assess, BC thresholds can be difficult to measure in individuals with severe-to-profound hearing loss because of vibrotactile responses to high-level, low-frequency stimulation and the potential contribution of hearing in the contralateral ear. Because of these technical barriers to measuring behavioral BC thresholds in implanted patients with residual hearing, it would be helpful to have an objective method for determining ABG. This study evaluated an innovative technique for measuring electrocochleographic (ECochG) responses using the cochlear microphonic (CM) response to assess AC and BC thresholds in implanted patients with residual hearing. Results showed high correlations between CM thresholds and behavioral audiograms for AC and BC conditions, thereby demonstrating the feasibility of using ECochG as an objective tool for quantifying ABG in CI recipients.

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“…Rowe et al [19] showed that the RW approach induced delayed low-frequency hearing loss which may be due to the muscle graft used to seal the RW incision. Hod et al [18] showed a similar degree of hearing loss between the RW and cochleostomy approaches in an animal model 1 week after surgery. Above all, few studies have a comprehensive evaluation to indicate the impact of these 2 surgical approaches for CI users using the same type of electrode.…”

Section: Introductionmentioning

confidence: 99%

“…Except for electrode impedance, residual hearing, insertion depth and speech perception were compared between the 2 approaches. The majority of results showed that the 2 approaches provided comparable results for preserving the residual hearing, insertion depth and speech perception [14][15][16][17][18]. Rowe et al [19] showed that the RW approach induced delayed low-frequency hearing loss which may be due to the muscle graft used to seal the RW incision.…”

Section: Introductionmentioning

confidence: 99%

Comparable Electrode Impedance and Speech Perception at 12 Months after Cochlear Implantation Using Round Window versus Cochleostomy: An Analysis of 40 Patients

Cheng

Wang

Liu

et al. 2018

ORL

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Objective: The objective of this study was to examine whether cochlear implantation using the round window (RW) route versus cochleostomy achieves comparable electrode impedance and hearing results. Methods: This retrospective analysis included 40 patients receiving a cochlear implant (REZ-1): 20 using the RW approach and the remaining 20 using cochleostomy. Electrode impedance and tone, vowel, consonant, disyllable and sentence perception were measured during and after the implantation. Results: Electrode impedance did not differ significantly between the 2 groups at any time points [F(1, 38) = 1.84; p = 0.184]: 1.87, 5.16, 6.47 and 6.70 kΩ in the RW group versus 2.86, 5.33, 6.92 and 8.16 kΩ in the cochleostomy group at 0, 1, 3 and 12 months, respectively. There was no significant difference between the RW and cochleostomy groups for tone (77.50 vs. 80.50%; p = 0.472), vowel (77.70 vs. 78.65%; p = 0.760), consonant (75.50 vs. 78.25%; p = 0.443), disyllable (78.60 vs. 81.50%; p = 0.317) and sentence (50.90 vs. 52.50%; p = 0.684) perception at 12 months. Conclusion: The RW approach is comparable to cochleostomy in electrode placement as reflected by impedance and function as reflected by tone, vowel, consonant, disyllable and sentence perception.

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Cochlear implantation via round window or cochleostomy: Effect on hearing in an animal model

Abstract: NA Laryngoscope, 126:E375-E378, 2016.

Cited by 4 publications

References 17 publications

A Guinea Pig Model Suggests That Objective Assessment of Acoustic Hearing Preservation in Human Ears With Cochlear Implants Is Confounded by Shifts in the Spatial Origin of Acoustically Evoked Potential Measurements Along the Cochlear Length

A Guinea Pig Model Suggests That Objective Assessment of Acoustic Hearing Preservation in Human Ears With Cochlear Implants Is Confounded by Shifts in the Spatial Origin of Acoustically Evoked Potential Measurements Along the Cochlear Length

An Objective Estimation of Air-Bone-Gap in Cochlear Implant Recipients with Residual Hearing Using Electrocochleography

Comparable Electrode Impedance and Speech Perception at 12 Months after Cochlear Implantation Using Round Window versus Cochleostomy: An Analysis of 40 Patients

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