The aims of this study were: (1) To investigate the correlation between electrophysiological changes during cochlear implantation and postoperative hearing loss, and (2) to detect the time points ...that electrophysiological changes occur during cochlear implantation.
Extra- and intracochlear electrocochleography (ECoG) were used to detect electrophysiological changes during cochlear implantation. Extracochlear ECoG recordings were conducted through a needle electrode placed on the promontory; for intracochlear ECoG recordings, the most apical contact of the cochlear implant (CI) electrode itself was used as the recording electrode. Tone bursts at 250, 500, 750, and 1000 Hz were used as low-frequency acoustic stimuli and clicks as high-frequency acoustic stimuli. Changes of extracochlear ECoG recordings after full insertion of the CI electrode were correlated with pure-tone audiometric findings 4 weeks after surgery.
Changes in extracochlear ECoG recordings correlated with postoperative hearing change (
= -0.44,
= 0.055,
= 20). Mean hearing loss in subjects without decrease or loss of extracochlear ECoG signals was 12 dB, compared to a mean hearing loss of 22 dB in subjects with a detectable decrease or a loss of ECoG signals (
= 0.0058,
= 51). In extracochlear ECoG recordings, a mean increase of the ECoG signal of 4.4 dB occurred after opening the cochlea. If a decrease of ECoG signals occurred during insertion of the CI electrode, the decrease was detectable during the second half of the insertion.
ECoG recordings allow detection of electrophysiological changes in the cochlea during cochlear implantation. Decrease of extracochlear ECoG recordings during surgery has a significant correlation with hearing loss 4 weeks after surgery. Trauma to cochlear structures seems to occur during the final phase of the CI electrode insertion. Baseline recordings for extracochlear ECoG recordings should be conducted after opening the cochlea. ECoG responses can be recorded from an intracochlear site using the CI electrode as recording electrode. This technique may prove useful for monitoring cochlear trauma intraoperatively in the future.
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. Patients who retain some residual acoustic hearing after surgery often can benefit from electro-acoustic stimulation (EAS) technologies, which combine conventional acoustic amplification with electrical stimulation. However, interactions between acoustic and electrical stimulation may affect outcomes adversely and are time-consuming and difficult to assess behaviorally. This study demonstrated the feasibility of using the Advanced Bionics HiRes90K Advantage implant electronics and HiFocus Mid Scala/1j electrode to measure electrocochleography (ECochG) responses in the presence of electrical stimulation to provide an objective estimate of peripheral physiologic EAS interactions. In general, electrical stimulation reduced ECochG response amplitudes to acoustic stimulation. The degree of peripheral EAS interaction varied as a function of acoustic pure tone frequency and the intra-cochlear location of the electrically stimulated electrode. Further development of this technique may serve to guide and optimize clinical EAS system fittings in the future.
The use of electrocochleography (ECochG) for providing real-time feedback of cochlear function during cochlear implantation is receiving increased attention for preventing cochlear trauma and ...preserving residual hearing. Although various studies investigated the relationship between intra-operative ECochG measurements and surgical outcomes in recent years, the limited interpretability of ECochG response changes leads to conflicting study results and prevents the adoption of this method for clinical use. Specifically, the movement of the recording electrode with respect to the different signal generators in intracochlear recordings makes the interpretation of signal changes with respect to cochlear trauma difficult. Here, we demonstrate that comparison of ECochG signals recorded simultaneously from intracochlear locations and from a fixed extracochlear location can potentially allow a differentiation between traumatic and atraumatic signal changes in intracochlear recordings. We measured ECochG responses to 500 Hz tone bursts with alternating starting phases during cochlear implant insertions in six human cochlear implant recipients. Our results show that an amplitude decrease with associated near 180° phase shift and harmonic distortions in the intracochlear difference curve during the first half of insertion was not accompanied by a decrease in the extracochlear difference curve’s amplitude (n = 1), while late amplitude decreases in intracochlear difference curves (near full insertion, n = 2) did correspond to extracochlear amplitude decreases. These findings suggest a role for phase shifts, harmonic distortions, and recording location in interpreting intracochlear ECochG responses.
There are three acoustical cues to sound location: Interaural time differences (ITDs), interaural level differences (ILDs), and monaural spectral shape cues. During development, the increasing ...interaural distance and pinnae size associated with a growing head and pinnae result in localization cues that change continuously until maturation is complete. Here the authors report measurements of both the physical dimensions of the head and pinnae, as well as acoustical measurements of the binaural localization cues of cats aged 1.3 weeks to adulthood. For a given source location, ILD magnitude tended to increase with both frequency and age. Moreover, the range of significant ILD production (approximately 10 dB) shifted with age from higher to lower frequencies. ITD magnitude increased with age. Partial correlation analyses revealed that increasing pinnae size accounted for approximately 31% of the variance in the development of ILDs while increasing head size accounted for virtually none. On the other hand, increases in both the head and pinnae sizes contributed to the development of the ITD cues accounting for approximately 71% and approximately 25% of the variance, respectively. ILD and ITD cues in cats reach maturity by approximately 16 and approximately 22 weeks, respectively, which match the time period over which the pinnae and head dimensions reach maturity.
Intraoperative electrocochleography (ECOG) is performed using a single low-frequency acoustic stimulus (e.g., 500 Hz) to monitor cochlear microphonics (CM) during cochlear implant (CI) electrode ...insertion. A decrease in CM amplitude is commonly associated with cochlear trauma and is used to guide electrode placement. However, advancement of the recording electrode beyond the sites of CM generation can also lead to a decrease in CM amplitude and is sometimes interpreted as cochlear trauma, resulting in unnecessary electrode manipulation and increased risk of cochlear trauma during CI electrode placement. In the present study, multi-frequency ECOG was used to monitor CM during CI electrode placement. The intraoperative CM tracings were compared with electrode scan measurements, where CM was measured for each of the intracochlear electrodes. Comparison between the peak CM amplitude measured during electrode placement and electrode scan measurements was used to differentiate between different mechanisms for decrease in CM amplitude during CI electrode insertion. Analysis of the data shows that both multi-frequency electrocochleography and electrode scan could potentially be used to differentiate between different mechanisms for decreasing CM amplitude and providing appropriate feedback to the surgeon during CI electrode placement.
There are three main cues to sound location: the interaural differences in time (ITD) and level (ILD) as well as the monaural spectral shape cues. These cues are generated by the spatial- and ...frequency-dependent filtering of propagating sound waves by the head and external ears. Although the chinchilla has been used for decades to study the anatomy, physiology, and psychophysics of audition, including binaural and spatial hearing, little is actually known about the sound pressure transformations by the head and pinnae and the resulting sound localization cues available to them. Here, we measured the directional transfer functions (DTFs), the directional components of the head-related transfer functions, for 9 adult chinchillas. The resulting localization cues were computed from the DTFs. In the frontal hemisphere, spectral notch cues were present for frequencies from ∼6–18 kHz. In general, the frequency corresponding to the notch increased with increases in source elevation as well as in azimuth towards the ipsilateral ear. The ILDs demonstrated a strong correlation with source azimuth and frequency. The maximum ILDs were <10 dB for frequencies <5 kHz, and ranged from 10–30 dB for the frequencies >5 kHz. The maximum ITDs were dependent on frequency, yielding 236 μs at 4 kHz and 336 μs at 250 Hz. Removal of the pinnae eliminated the spectral notch cues, reduced the acoustic gain and the ILDs, altered the acoustic axis, and reduced the ITDs.
► Sound pressure transformations by the head and pinnae of the adult chinchilla (
Chinchilla lanigera) produced monaural spectral notch cues for frequencies from ∼6–18 kHz. ► The maximum interaural level differences were <10 dB for frequencies <5 kHz, and ranged from 10–30 dB for the frequencies > 5 kHz. ► The maximum interaural time differences were dependent on sound frequency, yielding 236 μs at 4 kHz and 336 μs at 250 Hz. ► Removal of the pinnae eliminated the spectral notch cues, reduced the acoustic gain and the interaural level differences, altered the acoustic axis, and reduced the interaural time differences.
In this report we demonstrate that differences in cage type brought unexpected effects on aggressive behavior and neuroanatomical features of the mouse olfactory bulb. A careful characterization of ...two cage types, including a comparison of the auditory and temperature environments, coupled with a demonstration that naris occlusion abolishes the neuroanatomical changes, lead us to conclude that a likely important factor mediating the phenotypic changes we find is the olfactory environment of the two cages. We infer that seemingly innocuous changes in cage environment can affect sensory input relevant to mice and elicit profound effects on neural output. Study of the neural mechanisms underlying animal behavior in the laboratory environment should be broadened to include neuroethological approaches to examine how the laboratory environment (beyond animal well-being and enrichment) influences neural systems and behavior.
To test a method to measure the efficacy of active middle ear implants when coupled to the round window.
Data previously published in Koka et al. ( Hear Res 2010;263:128-137) were used in this study. ...Simultaneous measurements of cochlear microphonics (CM) and stapes velocity in response to both acoustic stimulation (forward direction) and round window (RW) stimulation (reverse direction) with an active middle ear implant (AMEI) were made in seven ears in five chinchillas. For each stimulus frequency, the amplitude of the CM was measured separately as a function of intensity (dB SPL or dB mV). Equivalent vibrational input to the cochlea was determined by equating the acoustic and AMEI-generated CM amplitudes for a given intensity. In the condition of equivalent CM amplitude between acoustic and RW stimulation-generated output, we assume that the same vibrational input to the cochlea was present regardless of the route of stimulation.
The measured stapes velocities for equivalent CM output from the two types of input were not significantly different for low and medium frequencies (0.25-4 kHz); however, the velocities for AMEI-RW drive were significantly lower for higher frequencies (4-14 kHz). Thus, for RM stimulation with an AMEI, stapes velocities can underestimate the mechanical input to the cochlea by ~20 dB for frequencies greater than ~4 kHz.
This study confirms that stapes velocity (with the assumption of equivalent stapes velocity for forward and reverse stimulation) cannot be used as a proxy for effective input to the cochlea when it is stimulated in the reverse direction. Future research on application of intraoperative electrophysiological measurements during surgery (CM, compound action potential, or auditory brainstem response) for estimating efficacy and optimizing device coupling and performance is warranted.
OBJECTIVES:To determine whether electrocochleography (ECoG) thresholds, especially cochlear microphonic and auditory nerve neurophonic thresholds, measured using an intracochlear electrode, can be ...used to predict pure-tone audiometric thresholds following cochlear implantation in ears with residual hearing.
DESIGN:Pure-tone audiometric thresholds and ECoG waveforms were measured at test frequencies from 125 to 4000 Hz in 21 Advanced Bionics cochlear implant recipients with residual hearing in the implanted ear. The “difference” and “summation” responses were computed from the ECoG waveforms measured from two alternating phases of stimulation. The interpretation is that difference responses are largely from the cochlear microphonic while summating responses are largely from the auditory nerve neurophonic. The pure-tone audiometric thresholds were also measured with same equipment used for ECoG measurements.
RESULTS:Difference responses were observed in all 21 implanted ears, whereas summation response waveforms were observed in only 18 ears. The ECoG thresholds strongly correlated (r = 0.87, n = 150 for difference response; r = 0.82, n = 72 for summation response) with audiometric thresholds. The mean difference between the difference response and audiometric thresholds was −3.2 (±9.0) dB, while the mean difference between summation response and audiometric thresholds was −14 (±11) dB. In four out of 37 measurements, difference responses were measured to frequencies where no behavioral thresholds were present.
CONCLUSIONS:ECoG thresholds may provide a useful metric for the assessment of residual hearing in cochlear implant subjects for whom it is not possible to perform behavioral audiometric testing.
Objective: Improper electrode placement during cochlear implant (CI) insertion can adversely affect speech perception outcomes. However, the intraoperative methods to determine positioning are ...limited. Because measures of electrode impedance can be made quickly, the goal of this study was to assess the relationship between CI impedance and proximity to adjacent structures. Methods: An Advanced Bionics CI array was inserted into a clear, plastic cochlea one electrode contact at a time in a saline bath (nine trials). At each insertion depth, response to biphasic current pulses was used to calculate access resistance (Ra), polarization resistance (Rp), and polarization capacitance (Cp). These measures were correlated to actual proximity as assessed by microscopy using linear regression models. Results: Impedance increased with insertion depth and proximity to the inner wall. Specifically, Ra increased, Cp decreased, and Rp slightly increased. Incorporating all impedance measures afforded a prediction model (r = 0.88) while optimizing for sub-mm positioning afforded a model with 78.3% specificity. Conclusion: Impedance in vitro greatly changes with electrode insertion depth and proximity to adjacent structures in a predicable manner. Significance : Assessing proximity of the CI to adjacent structures is a significant first step in qualifying the electrode-neural interface. This information should aid in CI fitting, which should help maximize hearing and speech outcomes with a CI. Additionally, knowledge of the relationship between impedance and positioning could have utility in other tissue implants in the brain, retina, or spinal cord.
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