Electrophysiological Measures in Cochlear Implantation
09-12, 11:45–12:15 (Europe/Istanbul), Audiology 1

<p>Results of cochlear implantation (CI) vary significantly among different patients. This variability depends on the functional integrity of the auditory nerve and structures of central auditory system, the location of the electrode array, and the performance of the implanted electronic device. An outcome of CI surgery is typically assessed using a battery of tests. The limitations of speech perception tests highlight the need for more objective outcome measures. With the rising numbers of CI surgeries in recent years, as well as the expansion of candidacy to wider groups of pediatric population, there is a greater need to standardize and optimize the surgical and diagnostic procedures to ensure consistent and favorable outcomes. Modern methods of computerized tomography and magnetic resonance imaging provide information about the location of electrodes, but they are powerless in determining the functional status of neural elements, the performance of the device, and predicting the results of CI. The electrophysiological methods provide registration of responses from structures at various levels of the auditory pathway to acoustic and electrical stimulation. Despite the certain advantages the widely used in clinical practice Neural Response Telemetry provides information only about the functional integrity of the auditory nerve fibres, which limits its ability to assess the state of overlying structures and explain the pronounced intra- and interindividual differences in CI results. This information can be obtained by recording the potentials of the brain stem and auditory cortex to electrical stimulation (EABR, ECAEP) which can more effectively activate the central auditory pathway, providing auditory perception and enabling development of speech perception skills.</p> <p>At the pre-operative stage, a transtympanic EABR could be used as an effective clinical procedure which can decrease the likelihood of placing a cochlear implant in a non-stimulable ear and may provide the clinician with a valuable tool for selection of the most appropriate ear for implantation. Additionally, the intra-operative implant-evoked EABR with the use of test electrode is recommended to identify the site of lesion in patients with auditory neuropathy spectrum disorders (presynaptic vs. postsynaptic).</p> <p>In CI patients, using the implant electrode, we can measure ECochG signals directly within the cochlea. Intraoperative intracochlear monitoring of the cochlear response (cochlear microphonic) to acoustic stimulation during CI shows promise as a tool to assist with hearing preservation.</p> <p>It is emphasized that the presence of the CAEP P1-N1-P2 complex with amplification can serve as an indicator of speech determination at the level of the auditory cortex. In addition, the possibility of using CAEP recording to assess the effectiveness of CI is being considered, and a high degree of correlation between CAEP thresholds and hearing thresholds is noted</p> <p>The electrophysiological provide the valuable information about the auditory pathway including cochlear hair cells, auditory nerve, brainstem and auditory cortex. Using different objective measures at different stages of CI we can identify the site of lesion (presynaptic vs. postsynaptic), the auditory nerve functional integrity and understand considerable variance in postoperative performance of CI users.</p>
<p>To provide a comprehensive overview of the electrophysiological methods and discuss their recent applications at different stages of cochlear implantation</p>
Session Chair Session Chair
Ahmet Atas
Speaker Speaker
George Tavartkiladze
George Tavartkiladze
<p>PROF. GEORGE A. TAVARTKILADZE, M.D., PHD.</p> <p>Director and founder of the National Research Centre for Audiology and Hearing Rehabilitation till 2022,</p> <p>Head of the Department of Clinical Audiology of the Russian Medical Academy for Continuing Professional Education, Moscow, Russia.</p> <p>Academician of the National Academy of Sciences of the Republic of Georgia, Honorary member of the International Society of AudiologyHonorary Member of the Italian and German Societies of Otorhinolaryngologists, Honorary Doctor of the National Academy of Sciences of Armenia, Honorary Member of the Ukrainian Association of Otiatricians, Otoneurosurgeons and Otoneurologists.</p> <p>MAIN RESEARCH INTERESTS: experimental and clinical audiology, electrophysiology of hearing, cochlear micromechanics, early detection, diagnosis and rehabilitation of hearing disorders, cochlear implantation (more than 500 publications).</p> <p>MEMBERSHIP IN PROFESSIONAL SOCIETIES, EXTRAMURAL ACTIVITIES:</p> <p>President of the International Academy of Otorhinolaryngology-Head and Neck Surgery; Past Secretary General of the International Society of Audiology; Member of the Expert Advisory Panel, World Health Organization; Member of the Lancet Commission on Hearing; President of the Russian Society of Audiology, Representative of Russian Federation in European Federation of Audiological Societies, Council member of the IERASG</p> <p>MEMBERSHIP IN THE EDITORIAL BOARDS</p> <p>Acta Otolaryngology; International Journal of Pediatric Otorhinolaryngology; Journal of Hearing Science; Audiology Research; Journal of International Advanced Otology; European Arch Otolaryngology; Vestnik Otorhinolaringol (Rus); Honorary Editor-in-Chief of Folia Otorhingologiae et Patologiae Respiratoria; Hearing, Balance & Communication; Italian J of Audiology and Phoniatrics.</p>
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Ahmet Atas
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