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Transcript
S2-15
Evaluation of cochlear implant patients having no electrically evoked compound action potential
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Ikeya J. , Kawano A. , Tsutsumi M. , Nishiyama N. , Kawaguchi S. , Tomizawa A. , Keshino Y. , Nonami N. ,
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Saito Y. , Ohashi M. , Suzuki M.
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Azabu Hospital, Otorhinolaryngological Clinic, Sapporo, Japan, 2Tokyo Medical University, Department of Otorhinolaryngology, Tokyo,
Japan, 3Japan Self Defense Forces Sapporo Hospital, Department of Otorhinolaryngology, Sapporo, Japan
Introduction: Objective measures are a widely used and valuable tool in the field of cochlear implants. One
objective measure of the auditory nerve´s response to electrical stimulation is the Electrically Evoked Compound
Action Potential (ECAP). This response is allows the clinician to directly measure auditory nerve potentials on
patients with Cochlear implant. In analyzing the physiological response to the electrical stimulation transmitted by
the implant, information can be obtained regarding the expected and actual function of the peripheral nerve.
Reliable response can be obtained in most cases of adults and children. However, in some cases no intraoperative response or reliable response is obtained. We report adult cases that had no ECAP response.
Materials and methods: Out of 644 cases which received cochlear implants between 1985 and 2013 at Tokyo
Medical University Hospital, we investigate 10 adult cases which did not show ECAPs in intra-operative
measurement. Measurement of ECAPs was carried out using Neural Response Telemetry (NRT™) software
(electrode 4, 12 and 20) for Cochlear devices and the Auditory Nerve Response Telemetry (ART™) feature of
the MED-EL MAESTRO system software (electrode 1, 5, 9, and 12) for MED-EL devices.
Results: The cases having no ECAP were 10 cases (2 males and 8 females). mean age 57 and range 32-79
years old. The etiologies of deafness were otitis media in 3 cases, meningitis in 2 cases, drug-induced in one
case, Meniere's disease in one case and unknown in three cases. Among 10 cases, 6 cases received Cochlear
devices and 4 cases received MED-EL devices. Devices used were CI24RE(CA) (5 cases), CI24M (1) and
CI422 (1) from Cochlear Co. and PULSAR (4 cases) from MED-EL Co. Four cases received more than one
operation including those who had the first operation at the other hospital. Speech perception was evaluated in
audition only in Japanese, and the average was 37.2 % (0〜84 %) in word and was 52.2 % in sentences.
Discussion: The reaction rate of ECAPs is generally more than 80% and becomes higher especially at intraoperation measurement. The rates of 96% for Cochlear devices and 86.6% for MED-EL devices have been
reported. However, some cases of no reaction were observed, we investigate these cases in this study.
The reasons for no ECAPs are considered to be meningitis in two cases, otitis media or flap infection in one case
and side effect of aminoglycoside drug in one case. There is also a bad example listening performance, but
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