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Predoperacijska elektrofiziološka obravnava otrok, kandidatov za polžkov vsadek = Preoperative neurophysiological assessment of children, candidates for cochlear implantation
Butinar, Dušan ; Gros, Anton, 1945-
Background: For electrophysiological assessment of children with profound cochlear hearing loss - candidates for cochlear implantation, electrocochleography (EcochG) and recording of electrically ...evoked auditory brain-stem responses (EABR) are used. They provide an objective measure of theinner ear cell damage and preservation of auditory nerve fibers which is a prerequisite for a successful cochlear implantation. Setting: the operating room. Patients: Since November 1998 we have tested 22 children, 14 girls and 8boys, aged 8 months to 16 years, in general anaesthesia and muscular relaxation Methods: 100 micro s alternating click stimuli were presented via the headphones to each ear. Electrocochleograms were recorded with needle electrode at the promontorium and surface electrode on the vertex. Stimuli consisting of 200 micro s inversed biphasic current pulses with intensity increasing from 600 microA to 1mA were provided by transtympanically placed promontory needle electrode. EABR were recorded with surface electrodes on thevertex and contralateral mastoid. The ground electrode was placed on the forehead at the beginning of the study, but was later moved to the ipsilateralmastoid, since this position was found associated with a substantially smaller artefact. Results: As expected, no electrocochleograms could be recorded in our children. EABR were obtained from 12 of the 22 patients tested. Mean EABR threshold was 690 microA (SD=110.3), mean wave V latency at the treshold was 4.8ms, and mean wave V amplitude was 0.25 micro V.Conclusion: Since one year, EcochG and EABR have been an integral component of the preoperative selection process for children who are candidates for cochlear implants. The ear with no EcochG and hogher EABR amplitude and lower threshold is chosen for implantation.
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