Abstract
There are two techniques for cochlear implant (CI) electrode placement: cochleostomy and the round window (RW) approach.Objective: This study aims to compare neural response telemetry (NRT) results immediately after surgery to check for possible differences on auditory nerve stimulation between these two techniques.Materials and Methods: This is a prospective cross-sectional study. Twenty-three patients were enrolled. Six patients underwent surgery by cochleostomy and 17 had it through the RW approach.Results: Mean charge units (MCU) for high frequency sounds: patients submitted to the RW approach had a mean value of 190.4 (±29.2) while cochleostomy patients averaged 187.8 (±32.7); p = 0.71. MCU for mid frequency sounds: patients submitted to the RW approach had a mean value of 192.5 (±22) while cochleostomy patients averaged 178.5 (±18.5); p = 0.23. MCU for low frequency sounds: patients submitted to the RW approach had a mean value of 183.3 (±25) while cochleostomy patients averaged 163.8 (±19.3); p = 0.19.Conclusion: This study showed no differences in the action potential of the distal portion of the auditory nerve in patients with multichannel cochlear implants submitted to surgery by cochleostomy or through the RW approach, using the implant itself to generate stimuli and record responses. Both techniques equally stimulate the cochlear nerve. Therefore, the choice of approach can be made based on the surgeon's own preference and experience.
Highlights
Brazil is estimated to have about 347,000 deaf individuals, many of them with indications for a cochlear implant
Mean charge units (MCU) for high frequency sounds: patients submitted to the round window (RW) approach had a mean value of 190.4 (± 29.2) while cochleostomy patients averaged 187.8 (± 32.7); p = 0.71
MCU for mid frequency sounds: patients submitted to the RW approach had a mean value of 192.5 (± 22) while cochleostomy patients averaged 178.5 (± 18.5); p = 0.23
Summary
Brazil is estimated to have about 347,000 deaf individuals, many of them with indications for a cochlear implant. For patients with little cochlear reserve who can not achieve good sound discrimination even with sound amplification, the cochlear implant (CI) is one option for their rehabilitation[1]. The cochlear implant brings about an improvement in hearing quality and improvements in speech perception and production, rendering a permanent and ascending quality-of-life gain in many aspects - such as self-sufficiency and socialization[2,3,4,5]. It is estimated that since the 70’s until today, there are 400 thousand implanted patients[6]. Cochlear implants partially replace the cochlea by turning sound into electrical signals[7]. The survival of enough neural structures in the cochlear nerve allows the transmission of electric stimuli to the cerebral cortex
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