12th International Conference on Cochlear Implants and Other Implantable Auditory Technologies

IntroductionDuring the last 3 years an extensive intra operative measurement protocol was used to objectively measure the function and interaction of the cochlear implant (CI) outcome measures of auditory nerve fibers (ECAP) and implant evoked electrically auditory brainstem responses (impEABR). The aim of this study is to find out if these measurements can be used as a predictor of speech and language outcomes.Method25 patients who were implanted with a Cochlear Corp. cochlear implant device, were investigated by measuring intra-OP for evoked compound action potential (ECAP) and implant evoked electrically auditory brainstem responses (impEABR). For ECAP measurements thresholds (AutoNRT) on each third electrode and sweeps at 220CL were obtained for all electrodes measuring the N1-P2 amplitude. For impEABR sweeps at 220CL were also obtained on all electrodes. These measurements were divided into three frequency areas; low frequency (electrode 20); middle frequency (electrode 13) and high frequency (electrode 6). The results from impEABR eV latency and amplitude and threshold levels of the T-ECAP and amplitude of the ECAP sweep of the intra-OP measurements were compared to speech and language performance with CI. We used a scaling system from 0-10 where “0” means absolutely no benefit with CI and “10” for the best performance. By using this category system all patients (small children to adults), all performance levels can be judged in a combined score. All patients had to use their CI for at least 9 months before performance evaluations were carried out.ResultsIntra-OP measurements have shown a wide spectrum of responses, as well there were differences for the measurements such as poor ECAP and good impEABR results within the same patient. Preliminary results have shown a good correlation between large impEABR responses and good performance with CI. Patients with poor and no impEABR responses have shown no performance increase with CI. Learning Objective: Assess that impEABR are intra-OP easy to achieve and do not extend surgical time Email: [email protected] Thursday (3:00 PM 5:00 PM) Marriott Grand 6 10 Presentation 65 Topic: Outcomes Title: Probability of improvement after cochlear implantation as a function of preoperative residual hearing Author(s): Bernard G Fraysse Presenter: Bernard G Fraysse Abstract: Introduction: The aim of this study was to evaluation the probability of improvement and the risk of decrement according to the level of preoperative functional hearingMaterials and Methods: In this retrospective study, we analyzed data from a sequential population of 144 unilateral cochlear implanted adult patients. This population was divided into three groups according to preoperative dissyllabic “Fournier” word recognition (60 dBSPL, 20 words) in the best-aided conditions: group 1 (n=65; 0-9% correct), group 2 (n=43; 10-29%) and group 3 (n=36; = 30%). We analyzed scores for dissyllabic word recognition in quiet and sentence recognition in noise (65 dBSPL at + 10 dB SNR). We considered speech recognition improvement as clinically significant if it was greater than 20%. The risk of decrement in performance was evaluated using distribution curves for each group, which display the proportion of patients showing a decrease in performance at one year.Results: In best-aided conditions for words in quiet, the mean improvement in percentage points was 69.0 (standard deviation, 24.0) for group 1, 57.6 (SD=14.8) for group 2 and 35.8 (SD=16.3) for group 3. Differences in improvement were significant between all groups (ANOVA, group 1 vs 2, p<0.01, 2 vs 3, p<0.001). For sentences in noise, the mean improvement was 70.2 (SD=24.0) for group 1.68.2 (SD=22.2) for group 2 and increased up to 53.0 (SD=23.7) for group 3. The difference in mean improvement was significant between group 1 and group 3 (p<0.01).Whether in quiet or in noise, no patient in any group decreased his/her best-aided speech recognition score. For word recognition, proportions of patients with an improvement exceeding 20% points were 97% in group 1, 100% in group 2 and 78% in group 3. These proportions were respectively 96%, 100% and 94% for sentences in noise.Conclusion: Patients with substantial residual hearing can receive benefit from cochlear Learning Objective: Precise the extension of cochlear implant in severe hearing loss Email: [email protected] Thursday (3:00 PM 5:00 PM) Marriott Grand 6 10 Presentation 66