Accuracy of intraoperative electrophysiological testing in confirming correct cochlear implant electrode positions

Abstract

Objective: To investigate the accuracy of intraoperative electrophysiological studies in detecting incorrectly positioned electrodes in cochlear implant surgery.

Study design: A retrospective chart review.

Setting: Tertiary referral centre.

Patients: In total, 104 consecutive patients with a mean age of 5 years underwent cochlear implant surgery at our centre between January 2012 and December 2013. All patients were implanted with Cochlear Nucleus Freedom implants.

Method: A retrospective study to compare intraoperative neural response telemetry (NRT), impedance and electrode position using Stenver’s transorbital plain X-ray view.

Results: Intraoperative electrophysiological tests for patients with Cochlear Nucleus Freedom implants showed 97% sensitivity and 100% specificity compared with postoperative X-ray imaging.

Conclusion: NRT results for the position of cochlear implants were very accurate when checked by X-ray imaging showing that this technique is sufficient in most cases. Stenver’s plain X-ray view is needed in complicated cases with abnormal NRT testing or difficult electrode insertion.

Keywords:

• Cochlear implants
• Intraoperative NRT
• Postoperative X-ray imaging
• Hearing loss

Notes on contributors

Ahmad Al Omari, MD, FACS, is a Consultant and Assistant Professor of Otolaryngology, School of Medicine of Jordan University of Science and Technology (JUST). He was graduated from the faculty of medicine at JUST in 2004 and get his Otolaryngology residency training in Jordan and then his fellowship in Stanford, USA. He is currently the chairman of the otolaryngology branch at Jordan University of Science and Technology. Dr. Al Omari had many published researches in many prestigious indexed Journals.

Amjad Nuiser, MD, is a Consultant and Associate Professor of Otolaryngology, School of Medicine of Jordan University of Science and Technology (JUST). He was graduated from the faculty of medicine at JUST in and get his Otolaryngology residency training in Jordan and then his fellowship in Otology, Italy. He is currently the chairman of the special surgery department oat Jordan University of Science and Technology. Dr. Nuiser had many published researches in many indexed Journals.

Majid Bani Ata, MD, is a Consultant and Assistant Professor of Otolaryngology, School of Medicine of Jordan University of Science and Technology (JUST). He was graduated from the faculty of medicine at JUST in and get his Otolaryngology residency training in Jordan and then his fellowship University of Toronto,Canada. Dr. Majid is actively involved with training and research projects.

Laith Khasawneh, MD, is a Consultant and Assistant Professor of Otolaryngology, School of Medicine of Hashemite University in Jordan. He was graduated from the faculty of medicine at JUST in and get his Otolaryngology residency training in Jordan and then his fellowship in Head and neck surgery in Italy. He is currently an active faculty at hashemite university and Prince Hamzah Hospital and actively involved in medical students and residents teaching and training, Beside his research projects.

Ala”a Alhowary, MD, is a Consultant and Assistant Professor of Anesthesiology at School of Medicine of Jordan University of Science and Technology (JUST). He was graduated from the faculty of medicine at Al Mustansiriya University, Iraq, and get his Anaesthesia residency training in Jordan and then his fellowship in Pediatric Anesthesia in Canada. He is currently an active faculty staff and has involved in teaching and training of both medical students and anesthesia residents, he has many publications in a very well known Journals.

Firas Alzoubi, MD, FRCS, is a Senior Consultant and Professor of Otolaryngology, School of Medicine of Jordan University of Science and Technology (JUST). He was graduated from the faculty of medicine at JUST in 1993 and get his Otolaryngology training in Jordan and then in Manchester, UK, where he was awarded the fellowship from the Royal College of Surgeons of Edinburgh in 1999. He is currently the director of the Cochlear Implant and Hearing Solutions Centre of King Abdullah University Hospital and vice chairman of the otolaryngology scientific committee of the Arab board. Prof. Alzoubi is a leading otologist and CI surgeon who is heavily involved with training, research and establishing state of the art CI centers all over the Arab world. He was awarded the ‘Karl Storz’ Award for Excellence in Teaching 2014 at the Middle East Otolaryngology Academy conference in Dubai For his huge contribution to the education of ENT physicians in the Middle East.

ORCID

Ahmad Al Omari http://orcid.org/0000-0002-6531-5164