Publication: Koklear implant kullanıcılarında postoperatif intrakoklear elektrokokleografi bulgularının incelenmesi
Abstract
Amaç: Çalışmanın amacı, işitsel nöropati spektrum bozukluğu (İNSB) olan koklear implant (Kİ) kullanıcılarından elde edilen intrakoklear elektrokokleografi (ECochG) bulgularını sensörinöral işitme kaybı (SNİK) olan Kİ kullanıcılarıyla karşılaştırmaktır. Ayrıca, koklear mikrofonik (KM) cevabı olan ve olmayan Kİ kullanıcılarının işitsel performansları ve spektral çözünürlük becerileri karşılaştırılmıştır. Gereç ve Yöntem: Çalışmamız, üniversite hastanesinde yapılmış tek merkezli, prospektif bir kohort çalışmasıdır. Katılımcılardan (N = 46) %59’u (N = 27) erkek ve %41’i (N = 19) kadın olmak üzere implante edilen 62 kulak çalışmamıza dahil edilmiştir. İNSB grubunda 29 kulak ve SNİK grubunda 33 kulak bulunmaktadır. Katılımcıların yaş ortalaması 11 yaştır. İntrakoklear ECochG testinde KM cevapları, Kİ kullanıcılarında 250 ile 2000 Hz arasında kaydedilmiştir. Her kullanıcıya aynı zamanda Spektral Dalga Ayırt etme (SDA) testi ile Konuşma, Uzaysal Algı ve İşitme Kalitesi (KUİK) ölçeği uygulanmış ve elde edilen sonuçlar istatistiksel olarak analiz edilmiştir. Bulgular: İntrakoklear ECochG bulguları, implante olan 62 kulakta (N = 46) kaydedilmiştir. Katılımcılar, KM cevaplarının elde edilip edilmemesine göre iki gruba ayrılmıştır. İNSB grubunda 29 kulağın 13'ünde ve SNİK grubunda 33 kulağın 14'ünde KM cevapları elde edilmiştir. İNSB grubunda bazı frekanslarda davranışsal işitme eşiklerine göre KM eşikleri daha iyi elde edilmiştir. KM cevabı olan ve olmayan Kİ kullanıcılarının işitsel performansları ve spektral çözünürlük bulguları arasında istatistiksel olarak anlamlı bir fark gözlenmemiştir. Sonuç: İntrakoklear EcochG, İNSB’yi takip etmek için klinik açıdan potansiyel bir değere sahiptir. Ancak, ECochG kullanılarak elde edilen KM eşikleri, davranışsal işitme eşiklerini güvenilir bir şekilde yansıtmayabilir.
Objectives: This study aimed to compare intracochlear electrocochleography (ECochG) findings in a group of cochlear implant (CI) recipients with auditory neuropathy spectrum disorder (ANSD) with a group of CI recipients with sensorineural hearing loss (SNHL). Auditory outcome and spectral resolution findings were also compared among CI recipients with and without cochlear microphonic (CM) responses. Materials and Methods: This single-center, prospective cohort study was undertaken at a tertiary referral center. CM responses by the intracochlear ECochG test were recorded in CI recipients at 250–2000 Hz. Speech, Spatial, and Hearing Quality (SSQ) outcomes and spectral resolution measured with the Spectral-Temporally Modulated Ripple Test (SMRT) were obtained for each recipient. The study included 62 implanted ears in 46 recipients, of which 59% (N = 27) were male and 41% (N = 19) were female. Twenty-nine ears with ANSD and 33 ears with SNHL were included. The mean age of the participants was 11 years. The results compared the intracochlear ECochG findings of the ANSD group with those of the SNHL group. Results: Participants were divided into two groups with and without obtainable CM responses. CM responses were obtained in 13 of 29 ears in the ANSD group and 14 of 33 ears in the SNHL group. CM thresholds obtained were better according to behavioral audiometric responses in some frequencies in the ANSD group. No significant difference was found in the auditory outcome and spectral resolution among CI recipients with and without CM responses. Conclusions: Intracochlear ECochG has a limited potential clinical value for monitoring ANSD. CM thresholds obtained using ECochG may not reflect behavioral hearing thresholds.
Objectives: This study aimed to compare intracochlear electrocochleography (ECochG) findings in a group of cochlear implant (CI) recipients with auditory neuropathy spectrum disorder (ANSD) with a group of CI recipients with sensorineural hearing loss (SNHL). Auditory outcome and spectral resolution findings were also compared among CI recipients with and without cochlear microphonic (CM) responses. Materials and Methods: This single-center, prospective cohort study was undertaken at a tertiary referral center. CM responses by the intracochlear ECochG test were recorded in CI recipients at 250–2000 Hz. Speech, Spatial, and Hearing Quality (SSQ) outcomes and spectral resolution measured with the Spectral-Temporally Modulated Ripple Test (SMRT) were obtained for each recipient. The study included 62 implanted ears in 46 recipients, of which 59% (N = 27) were male and 41% (N = 19) were female. Twenty-nine ears with ANSD and 33 ears with SNHL were included. The mean age of the participants was 11 years. The results compared the intracochlear ECochG findings of the ANSD group with those of the SNHL group. Results: Participants were divided into two groups with and without obtainable CM responses. CM responses were obtained in 13 of 29 ears in the ANSD group and 14 of 33 ears in the SNHL group. CM thresholds obtained were better according to behavioral audiometric responses in some frequencies in the ANSD group. No significant difference was found in the auditory outcome and spectral resolution among CI recipients with and without CM responses. Conclusions: Intracochlear ECochG has a limited potential clinical value for monitoring ANSD. CM thresholds obtained using ECochG may not reflect behavioral hearing thresholds.