Digital real-time visualization of intraoperative electrocochleography during cochlear implantation – a prospective randomized study of 50 patients.

Introduction Real-time visualization of intraoperative electrocochleography (ECochG) potentials via a digital microscope during cochlear implantation can provide direct feedback during electrode insertion. The aim of this prospective, randomized study of 50 patients was to obtain long-term data related to residual hearing preservation and speech understanding.

Material and Methods Cochlear implantations (Cochlear ©) were performed in 50 patients (25 women) with residual hearing using a digital microscope (ARRISCOPE). Patients were randomized into two groups. Intraoperative ECochG potentials were displayed directly in the surgeon’s field of view (group I, picture-in-picture display) or not directly in the field of view (group II, without picture-in-picture display). Residual hearing preservation as well as speech comprehension was recorded within a 1-year follow-up period.

Results Mean insertion time was significantly longer in the picture-in-picture group (p<0.05). Residual hearing preservation after 1 year was possible at 250 Hz in the picture-in-picture technique in 76% of cases (62% without picture-in-picture technique). Use of the picture-in-picture technique resulted in higher long-term tonaudiometric residual hearing preservation at 250, 500, and 1000 Hz. Speech intelligibility improved by 44% in the picture-in-picture group (40% without picture-in-picture).

Discussion This study is the first to describe long-term results in a large cohort of cochlear implant patients in whom digital visualization of intraoperative electrocochleography was used. Our results show that visualization of intraoperative electrocochleography has a significant positive effect on residual hearing preservation.

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Artikel online veröffentlicht:
12. Mai 2023