Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-17T17:21:18.176Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of cochlear implant electrode insertion on middle-ear function as measured by intra-operative laser Doppler vibrometry

Published online by Cambridge University Press:  13 January 2009

N Donnelly ,
A Bibas ,
D Jiang ,
D-E Bamiou ,
C Santulli ,
G Jeronimidis  and
A Fitzgerald O'Connor
N Donnelly
Affiliation:
Auditory Implantation Unit, Department of Otolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospitals, London, UK
A Bibas
Affiliation:
Auditory Implantation Unit, Department of Otolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospitals, London, UK Department of Otolaryngology – Head and Neck Surgery, Hippokrateion Hospital, University of Athens Medical School, Greece
D Jiang
Affiliation:
Auditory Implantation Unit, Department of Otolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospitals, London, UK
D-E Bamiou
Affiliation:
Department of Neurotology, Institute of Neurology and Neurosurgery, Queen's Square, London, UK
C Santulli
Affiliation:
Centre for Biomimetics, School of Construction Management and Engineering, University of Reading, UK
G Jeronimidis
Affiliation:
Centre for Biomimetics, School of Construction Management and Engineering, University of Reading, UK
A Fitzgerald O'Connor*
Affiliation:
Auditory Implantation Unit, Department of Otolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospitals, London, UK
*
Address for correspondence: Mr A Fitzgerald O'Connor, Department of Otolaryngology, Head and Neck Surgery, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK. E-mail: afoc@globalnet.co.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Hypothesis:

The aim of this study was to investigate the impact of cochlear implant electrode insertion on middle-ear low frequency function in humans.

Background:

Preservation of residual low frequency hearing with addition of electrical speech processing can improve the speech perception abilities and hearing in noise of cochlear implant users. Preservation of low frequency hearing requires an intact middle-ear conductive mechanism in addition to intact inner-ear mechanisms. Little is known about the effect of a cochlear implant electrode on middle-ear function.

Methods:

Stapes displacement was measured in seven patients undergoing cochlear implantation. Measurements were carried out intra-operatively before and after electrode insertion. Each patient acted as his or her own control. Sound was delivered into the external auditory canal via a speaker and calibrated via a probe microphone. The speaker and probe microphone were integrated into an individually custom-made ear mould. Ossicular displacement in response to a multisine stimulus at 80 dB SPL was measured at the incudostapedial joint via the posterior tympanotomy, using an operating microscope mounted laser Doppler vibrometry system.

Results:

Insertion of a cochlear implant electrode into the scala tympani had a variable effect on stapes displacement. In three patients, there was little change in stapes displacement following electrode insertion. In two patients, there was a significant increase, while in a further two there was a significant reduction in stapes displacement. This variability may reflect alteration of cochlear impedance, possibly due to differing loss of perilymph associated with the electrode insertion.

Conclusion:

Insertion of a cochlear implant electrode produces a change in stapes displacement at low frequencies, which may have an effect on residual low frequency hearing thresholds.

Keywords

Cochlear ImplantMiddle EarPhysiologyLaser Doppler Vibrometry
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 7 , July 2009 , pp. 723 - 729
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Gantz, BJ, Turner, CW. Combining acoustic and electrical hearing. Laryngoscope 2003;113:1726–30CrossRefGoogle ScholarPubMed
2 Turner, CW, Gantz, BJ, Vidal, C, Behrens, A, Henry, BA. Speech recognition in noise for cochlear implant listeners: benefits of residual acoustic hearing. J Acoust Soc Am 2004;115:1729–35CrossRefGoogle ScholarPubMed
3 von Ilberg, C, Kiefer, J, Tillein, J, Pfenningdorff, T, Hartmann, R, Sturzebecher, E et al. Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss. ORL J Otorhinolaryngol Relat Spec 1999;61:334–40CrossRefGoogle ScholarPubMed
4 Kiefer, J, Gstoettner, W, Baumgartner, W, Pok, SM, Tillein, J, Ye, Q et al. Conservation of low-frequency hearing in cochlear implantation. Acta Otolaryngol 2004;124:272–80CrossRefGoogle ScholarPubMed
5 Kiefer, J, Pok, M, Adunka, O, Sturzebecher, E, Baumgartner, W, Schmidt, M et al. Combined electric and acoustic stimulation of the auditory system: results of a clinical study. Audiol Neurotol 2005;10:134–44CrossRefGoogle ScholarPubMed
6 Gantz, BJ, Turner, CW, Gfeller, KE, Lowder, MW. Preservation of hearing in cochlear implant surgery: advantages of combined electrical and acoustical speech processing. Laryngoscope 2005;115:796–802CrossRefGoogle ScholarPubMed
7 Gstoettner, W, Kiefer, J, Baumgartner, WD, Pok, S, Peters, S, Adunka, O. Hearing preservation in cochlear implantation for electric acoustic stimulation. Acta Otolaryngol 2004;124:348–52CrossRefGoogle ScholarPubMed
8 Huber, AM, Schwab, C, Linder, T, Stoeckli, SJ, Ferrazzini, M, Dillier, N et al. Evaluation of eardrum laser Doppler interferometry as a diagnostic tool. Laryngoscope 2001;111:501–7CrossRefGoogle ScholarPubMed
9 Voss, SE, Rosowski, JJ, Merchant, SN, Peake, WT. Acoustic responses of the human middle ear. Hear Res 2000;150:43–69CrossRefGoogle ScholarPubMed
10 Aibara, R, Welsh, JT, Puria, S, Goode, RL. Human middle-ear sound transfer function and cochlear input impedance. Hear Res 2001;152:100–9CrossRefGoogle ScholarPubMed
11 Gan, RZ, Wood, MW, Dormer, KJ. Human middle ear transfer function measured by double laser interferometry system. Otol Neurotol 2004;25:423–35CrossRefGoogle ScholarPubMed
12 Needham, AJ, Jiang, D, Bibas, A, Jeronimidis, G, Fitzgerald O'Connor, A. The effects of mass loading the ossicles with a floating mass transducer on middle ear transfer function. Otol Neurotol 2005;26:218–24CrossRefGoogle ScholarPubMed
13 Huber, A, Linder, T, Ferrazzini, M, Schmid, S, Dillier, N, Stoeckli, S et al. Intraoperative assessment of stapes movement. Ann Otol Rhinol Laryngol 2001;110:31–5CrossRefGoogle ScholarPubMed
14 Chien, W, Ravicz, ME, Merchant, SN, Rosowski, JJ. The effect of methodological differences in the measurement of stapes motion in live and cadaver ears. Audiol Neurotol 2006;11:183–97CrossRefGoogle ScholarPubMed
15 Chien, W, Rosowski, JJ, Ravicz, ME, Merchant, SN. Measurements of stapes velocity in live human ears. 29th Midwinter research meeting of the Association for Research in Otolaryngology. 2006. Abstract 641Google Scholar
16 Murakami, S, Gyo, K, Goode, RL. Effect of increased inner ear pressure on middle ear mechanics. Otolaryngol Head Neck Surg 1998;118:703–8Google ScholarPubMed
17 Gunderson, T, Høgmoen, K. Holographic vibration analysis of the ossicular chain. Acta Otolaryngol 1976;82:16–25CrossRefGoogle Scholar
18 Gyo, K, Aritomo, H, Goode, RL. Measurement of the ossicular vibration ratio in human temporal bones by use of a video measurement system. Acta Otolaryngol 1987;103:87–95CrossRefGoogle Scholar
19 Lord, RM, Abel, EW, Wang, Z. Effects of draining cochlear fluids on stapes displacement in middle-ear models. J Acoust Soc Am 2001;110:3132–9CrossRefGoogle ScholarPubMed
20 Gan, RZ, Sun, Q, Dyer, RK. Three-dimensional modelling of middle ear biomechanics and its application. Otol Neurotol 2002;23:271–2CrossRefGoogle Scholar
21 Mynatt, R, Hale, SA, Gill, RM, Plontke, SK, Salt, AN. Demonstration of a longitudinal concentration gradient along the scala tympani by sequential sampling of perilymph from the cochlear apex. JARO 2006;7:182–93CrossRefGoogle ScholarPubMed