The Role of Auditory Evoked Potentials in the Context of Cochlear Implant Provision

Hoth, Sebastian; Dziemba, Oliver

doi:10.1097/mao.0000000000001480

Cited by 21 publications

(22 citation statements)

References 37 publications

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“…However, clinical routine suffers from a lack of adequate preoperative measures 22 . Peri‐ and postoperative measures of compound action potentials are currently in the focus of many studies 24,25 . They may potentially explain the remaining variability, yet they apparently cannot contribute to the preoperative counseling of CI candidates.…”

Section: Discussionmentioning

confidence: 99%

Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

Hoppe

Hocke²,

Hast

et al. 2020

The Laryngoscope

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Objectives/Hypothesis To determine the improvement in word recognition score (WRS65) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65[CI]) 6 months after surgery, derived from the standard German CI preoperative assessment. Study Design Retrospective chart review. Methods Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center. Results The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65(CI) versus WRS65 with an (HA) (WRS65[HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65(CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65(HA) were identified as predictive factors for WRS65(CI). For three‐quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65(CI). Conclusions For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group. Level of Evidence 4 Laryngoscope, 131:E940–E945, 2021

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Section: Discussionmentioning

confidence: 99%

Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

Hoppe

Hocke²,

Hast

et al. 2020

The Laryngoscope

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“…The effect on other ECAP-based clinical application as e.g. described in [ 14 ] is also to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Fine-grain recordings of the electrically evoked compound action potential amplitude growth function in cochlear implant recipients

2018

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BackgroundIn cochlear implants (CI) measuring the electrically evoked compound action potential (ECAP) has become an important tool for verifying the electrode-nerve interface as well as establishing a basis for a map to program the speech processor. In a standard clinical setup recordings are averaged over 25–100 repetitions to allow for the detection of ECAPs within the noise floor. To obtain an amplitude growth function, these measurements are normally performed for 5–10 different stimulation levels. We evaluate a recording paradigm where the stimulation intensity is increased in quasi-continuous steps and instead of averaging repeated recordings with identical stimulation parameters, running averages over small intervals of stimulation levels are computed. The first visible nerve response was manually identified by two experts.ResultsBoth recording paradigms were evaluated in 39 cochlear implants, showing an on average lower threshold of the first nerve response for the quasi-continuous measurement paradigm (Wilcoxon signed-rank test, p = 6.2e−08) compared to the clinical standard paradigm. The mean maximal loudness over all implants and stimulation electrodes was 13% lower at the 80 pulses/s quasi-continuous paradigm compared to the 44 pulses/s clinical standard paradigm.ConclusionsBeside a more robust determination of the ECAP threshold, the proposed quasi-continuous stimulation paradigm results in a more robust behavioral feedback of the CI user upon the maximal acceptable loudness percept. Furthermore this paradigm can also reveal the fine-structure in the amplitude growth function.

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“…In the present study, we showed that it is also feasible to record MLRs in CI users elicited by chirp stimuli presented under free-field listening conditions. Because most studies have used electrical stimulation to record MLRs from CI users (Hoth and Dziemba, 2017), the present findings demonstrated the significant potential of the free-field presented chirp stimuli for the evaluation of CIs in clinical settings. However, more studies are needed to properly determine the clinical value of the measures obtained with the chirp stimulus.…”

Section: Chirp Stimuli As a Reliable Alternative To Click Stimuli Formentioning

confidence: 64%

Middle Latency Responses to Optimized Chirps in Adult Cochlear Implant Users

Alemi

Lehmann

2019

J Am Acad Audiol

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Cochlear implant (CI) outcomes can be assessed using objective measures that reflect the integrity of the auditory pathway. One such measure is the middle latency response (MLR), which can provide valuable information for clinicians.Traditional stimuli for evoking MLRs, that is, clicks or tone bursts, do not stimulate all parts of the cochlea simultaneously, whereas chirp stimuli compensate for the cochlear neural delay and, therefore, produce more synchronous responses from the different neural elements of the cochlea. The purpose of the present study was to determine whether chirp stimuli can elicit reliable MLRs in CI users and whether those responses correlate with clinical outcomes and with deprivation-related factors.We presented 2,000 free-field optimized chirp stimuli to CI and control participants while their electroencephalography (EEG) was being recorded.Twenty-four adult CI users and 24 matched normal-hearing (NH) individuals (age range from 18 to 63 years) participated in this study.The EEG was recorded from 64 active electrodes placed on the scalp. EEG signals were processed using EEGLAB and ERPLAB toolboxes. We characterized the latencies and amplitudes of the different MLR components in both groups.Chirp stimuli reliably evoked qualitatively similar MLRs across all NH and CI participants with a couple of differences observed between the NH and CI group. Among the different MLR components, the Na latency was significantly shorter for the CI group. A significant amplitude difference was also found between groups for the Pa–Nb complex, with higher amplitudes observed in the NH group. Finally, there were no significant correlations between MLR latencies (or amplitudes) and clinical outcomes or deprivation-related measures.Free-field–presented optimized chirp stimuli were shown to evoke measurable and reliable MLRs in CI users. In this experiment, the MLR morphology in CI users was similar to those observed in NH participants. Even though we did not replicate here a significant relationship between MLR and speech perception measures, we were able to successfully collect acoustically evoked MLRs, which could constitute an important supplemental measure to the standard behavioral tests presently being used in postoperative clinical evaluation settings.

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The Role of Auditory Evoked Potentials in the Context of Cochlear Implant Provision

Cited by 21 publications

References 37 publications

Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

Fine-grain recordings of the electrically evoked compound action potential amplitude growth function in cochlear implant recipients

Middle Latency Responses to Optimized Chirps in Adult Cochlear Implant Users

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