Investigating the association of electrically-evoked compound action potential thresholds with inner-ear dimensions in pediatric cochlear implantation

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Söderqvist , S , Sivonen , V , Lamminmäki , S , Ylönen , J , Markkola , A & Sinkkonen , S T 2022 , ' Investigating the association of electrically-evoked compound action potential thresholds with inner-ear dimensions in pediatric cochlear implantation ' , International Journal of Pediatric Otorhinolaryngology , vol. 158 , 111160 . https://doi.org/10.1016/j.ijporl.2022.111160

Title: Investigating the association of electrically-evoked compound action potential thresholds with inner-ear dimensions in pediatric cochlear implantation
Author: Söderqvist, Samuel; Sivonen, Ville; Lamminmäki, Satu; Ylönen, Jere; Markkola, Antti; Sinkkonen, Saku T.
Contributor organization: Korva-, nenä- ja kurkkutautien klinikka
HUS Head and Neck Center
University of Helsinki
Päijät-Häme Welfare Consortium
Clinicum
HUS Medical Imaging Center
Date: 2022-07
Language: eng
Number of pages: 11
Belongs to series: International Journal of Pediatric Otorhinolaryngology
ISSN: 0165-5876
DOI: https://doi.org/10.1016/j.ijporl.2022.111160
URI: http://hdl.handle.net/10138/345945
Abstract: Objectives: A narrow bony cochlear nerve canal (BCNC), as well as a hypoplastic and aplastic cochlear nerve (CN) have been associated with increased electrically-evoked compound action potential (eCAP) thresholds in some studies, suggesting poorer neural excitability in cochlear implantation. Also, in large cochleae the extent of activated spiral ganglion neurons with electrical stimulation is less than in smaller ones. However, a detailed description of the relationship between eCAP thresholds for a lateral-wall electrode array and dimensions of the inner-ear structures and internal auditory canal (IAC) is missing. Design: The study subjects were 52 pediatric patients with congenital severe-to-profound hearing loss (27 females and 25 males; ages 0.7-2.0 years; 1.0 +/- 0.3 years, mean +/- SD) implanted bilaterally with Cochlear Nucleus CI422, CI522, or CI622 implants with full insertion of the Slim Straight electrode array. Diameters of the cochlea and the BCNC as well as the widths and heights of the IAC and the CN were evaluated from preoperative computed tomography and magnetic resonance images. These anatomical dimensions were compared with each other and with the patients' intraoperative eCAP thresholds. Results: The eCAP thresholds increased from the apical to basal direction (r = 0.89, p < 0.001). After sorting the cochleae into four size categories, higher eCAP thresholds were found in larger than in smaller cochleae (p < 0.001). With similar categorization, the eCAP thresholds were higher in cochleae with a larger BCNC than in cochleae with a smaller BCNC (p < 0.001). Neither IAC nor CN cross-sectional areas affected the eCAP thresholds. Correlations were found between cochlea and BCNC diameters and between IAC and CN cross-sectional areas (r = 0.39 and r = 0.48, respectively, p < 0.001 for both). Conclusions: In the basal part of the electrode array, higher stimulation levels to elicit measurable neural responses (eCAP thresholds) were required than in the apical part. Increased eCAP thresholds associated with a larger cochlear diameter, but contrary to the earlier studies, not with a small size of the BCNC or the CN. Instead, the BCNC diameter correlated significantly with the cochlea diameter.
Subject: Cochlear implant
Electrically-evoked compound action potential
Cochlea diameter
Cochlear nerve
Inner ear dimension
NERVE
CHILDREN
DIAMETER
POSITION
OUTCOMES
HEARING
AREA
3125 Otorhinolaryngology, ophthalmology
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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