CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S210
DOI: 10.1055/s-0041-1728403
Abstracts
Otology / Neurotology / Audiology

Development of a system for intraoperative real-time monitoring of the insertion progress during cochlear implantation by measuring facial nerve stimulation

K Rak
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
,
D Herrmann
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
,
M Cebulla
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
,
J Taeger
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
,
S Kaulitz
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
,
R Hagen
1   Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg
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    The insertion of the electrode array of a cochlear implant (CI) represents a "black box". There are approaches to measure the progress of insertion by means of continuous measurement of impedances, eCAPs or by ECochG . The spatial resolution of these methods is not very high, they are rather used to check implant function or residual hearing. The aim of the study was to use intracochlear facial nerve stimulation to demonstrate the progress of insertion

    For this purpose, a system was developed to stimulate the facial nerve during the insertion process intracochlearly in an electrode-specific manner. The system was evaluated intraoperatively in 20 subjects during cochlear implantation. During insertion, stimulation was performed on the most apical contact of the electrode array. After successful insertion, a profile of all contacts was generated. The electromyogram (EMG) was recorded using needle electrodes.

    During the insertion procedure, an increase in the EMG and a decrease in its further course could be shown, which can be explained by the approximation and distancing of the stimulating contact from the facial nerve. The profile showed a peak in the area of the contacts that showed the greatest proximity to the facial nerve in postoperative radiological imaging.

    By means of intracochlear measurement of intracochlear facial nerve stimulation, a system was developed to display the insertion progress with high spatial resolution. Further investigations are necessary to determine the ideal stimulation intensity, which can then further increase the accuracy of the measurements. In addition, the system can be combined with a preoperative determination of the electrode contact, which should be located closest to the facial nerve and be used as a steering instrument.

    Poster-PDF A-1138.pdf


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    Conflict of interest

    Der Erstautor gibt keinen Interessenskonflikt an.

    Address for correspondence

    Priv. -Doz. Dr. med. Rak Kristen
    Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg
    Würzburg
    Email: Rak_k@ukw.de

    Publication History

    Article published online:
    13 May 2021

    © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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