Peri-operative electrically evoked auditory brainstem response assessment of facial nerve/cochlea interaction at cochlear implantation.

Autor: Schart-Morén N; a Department of Surgical Sciences, Section of Otolaryngology, Head and Neck Surgery , Uppsala University Hospital , Uppsala SE-75185 , Sweden., Hallin K; a Department of Surgical Sciences, Section of Otolaryngology, Head and Neck Surgery , Uppsala University Hospital , Uppsala SE-75185 , Sweden., Agrawal SK; b Department of Otolaryngology - Head and Neck Surgery , Western University, 1151 Richmond Street , London , ON , Canada, N6A3K7., Ladak HM; c Department of Otolaryngology - Head and Neck Surgery, Department of Medical Biophysics, Department of Electrical and Computer Engineering , Western University, 1151 Richmond Street , London , ON , Canada, N6A3K7., Eriksson PO; a Department of Surgical Sciences, Section of Otolaryngology, Head and Neck Surgery , Uppsala University Hospital , Uppsala SE-75185 , Sweden., Li H; a Department of Surgical Sciences, Section of Otolaryngology, Head and Neck Surgery , Uppsala University Hospital , Uppsala SE-75185 , Sweden., Rask-Andersen H; a Department of Surgical Sciences, Section of Otolaryngology, Head and Neck Surgery , Uppsala University Hospital , Uppsala SE-75185 , Sweden.
Jazyk: angličtina
Zdroj: Cochlear implants international [Cochlear Implants Int] 2018 Nov; Vol. 19 (6), pp. 324-329. Date of Electronic Publication: 2018 Jun 07.
DOI: 10.1080/14670100.2018.1481179
Abstrakt: Objectives: Dehiscence between the cochlear otic capsule and the facial nerve canal is a rare and relatively newly described pathology. In cochlear implantation (CI), this dehiscence may lead to adverse electric facial nerve stimulation (FNS) already at low levels, rendering its use impossible. Here, we describe an assessment technique to foresee this complication.
Methods: Pre- and postoperative computed tomography (CT) scans and intraoperative electrically evoked auditory brainstem response (e-ABR) measurements were analyzed in two patients with cochlear-facial dehiscence (CFD).
Results: Because of the relatively low resolution, the confirmation of CFD with a clinical CT was difficult. The e-ABR displayed a large potential with 6 and 7.5 ms latency, respectively, which did not occur otherwise.
Discussion: Potential strategies to resolve and manage FNS are described.
Conclusion: Prediction of FNS by assessing the distance between the labyrinthine portion of the facial nerve and the cochlea is difficult using conventional CT scans. A large evoked late myogenic potential at low stimulation levels during intraoperative e-ABR measurement may foresee FNS at CI activation.
Databáze: MEDLINE
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