Enhancing Surgical Precision and Hearing Outcomes: Intraoperative Auditory Steady-state Response Measurements in Active Middle Ear Implant Surgery.

STUDY

DESIGN

Prospective data analysis.

OBJECTIVE

The intraoperative measurement of auditory brainstem responses (ABR) enables the assessment of the coupling efficiency in active middle ear implant surgeries. Furthermore, auditory steady-state response (ASSR) measurements can offer additional frequency-specific evaluations. This study aims to examine the efficacy of intraoperative ASSR and ABR measurements and optimize implant placement during surgery.

MATERIALS AND

METHODS

Tertiary referral center with an extensive active middle ear implant program. Main outcome measures: Intraoperative ABR and ASSR measurements were conducted using a standard ABR system and the AcoustiAP adapter. After the surgical procedure, vibrogram thresholds were measured. The statistical analysis determined correlations between intraoperative ASSR and ABR thresholds, preoperative bone conduction, and postoperative vibrogram thresholds.

RESULTS

All patients underwent successful intraoperative recording of ABR and ASSR measurements. The ASSR thresholds exhibited a high correlation with bone conduction thresholds at 1000 Hz, 2000 Hz, and 4000 Hz. Furthermore, ASSR thresholds demonstrated robust correlations with postoperative vibrogram thresholds.

CONCLUSION

Intraoperative ASSR measurements can provide valuable real-time feedback for ensuring optimal placement during implantation due to their good correlation with bone conduction. The high correlation between intraoperative ASSR and postoperative vibrogram thresholds indicates that ASSR can also assess postoperative hearing outcomes. Further development and implementation of these measurements in the clinical routine might improve surgical outcomes by enabling more precise frequency-specific assessments, improving both coupling efficiency and postoperative hearing results.