Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2025
Intraoperative eSRTs: Feasibility of Measurement and Correlation With Postoperative eSRTs.
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MacDonald Andrina, Gifford René H, Sisler-Dinwiddie Allyson, Dwyer Nichole, Tawfik Kareem, Holder Jourdan T
Аннотация
OBJECTIVE: To assess the feasibility of intraoperative visual electrically evoked stapedial reflex threshold (eSRT) measurement using the Cochlear SmartNav 2 system, the correlation between intraoperative and postoperative eSRTs, and the correlation between eSRTs measured at 1 and 6 months post-activation.
STUDY DESIGN: Prospective.
SETTING: Cochlear implant (CI) program at a tertiary medical center.
PATIENTS: Fourteen adult CI users.
MAIN OUTCOME MEASURES: Intraoperative eSRTs and postoperative eSRTs.
RESULTS: Intraoperative eSRTs were successfully measurable on 11 of 14 participants and took approximately 3 minutes to measure. The mean intraoperative eSRT was 13.3 charge units higher than the mean 1-month post-activation eSRT ( p < 0.0001). The mean difference between the intraoperative and 1-month post-activation eSRT was 17.5, 15.3, 11.1, 10.5, and 11.8 nC/phase for electrodes 1, 6, 11, 16, and 22, respectively. The combined intraoperative eSRT data for all patients and all electrodes had a standard deviation of 8.5 charge units, whereas the combined 1-month post-activation eSRT data had a standard deviation of 3.2 charge units demonstrating greater intraoperative variability. The mean difference between the 1-month and 6-month post-activation eSRT was 0.2 charge units ( p > 0.999).
CONCLUSIONS: Intraoperative eSRT measurement is feasible and time-efficient in adult CI patients. The mean difference between the intraoperative and 1-month post-activation eSRT is similar across the array. However, intraoperative eSRTs are more variable than post-activation eSRTs, and thus, further investigation is needed to reduce this variability and create a clinically useful correction factor. Finally, postoperative eSRTs are stable over time.
STUDY DESIGN: Prospective.
SETTING: Cochlear implant (CI) program at a tertiary medical center.
PATIENTS: Fourteen adult CI users.
MAIN OUTCOME MEASURES: Intraoperative eSRTs and postoperative eSRTs.
RESULTS: Intraoperative eSRTs were successfully measurable on 11 of 14 participants and took approximately 3 minutes to measure. The mean intraoperative eSRT was 13.3 charge units higher than the mean 1-month post-activation eSRT ( p < 0.0001). The mean difference between the intraoperative and 1-month post-activation eSRT was 17.5, 15.3, 11.1, 10.5, and 11.8 nC/phase for electrodes 1, 6, 11, 16, and 22, respectively. The combined intraoperative eSRT data for all patients and all electrodes had a standard deviation of 8.5 charge units, whereas the combined 1-month post-activation eSRT data had a standard deviation of 3.2 charge units demonstrating greater intraoperative variability. The mean difference between the 1-month and 6-month post-activation eSRT was 0.2 charge units ( p > 0.999).
CONCLUSIONS: Intraoperative eSRT measurement is feasible and time-efficient in adult CI patients. The mean difference between the intraoperative and 1-month post-activation eSRT is similar across the array. However, intraoperative eSRTs are more variable than post-activation eSRTs, and thus, further investigation is needed to reduce this variability and create a clinically useful correction factor. Finally, postoperative eSRTs are stable over time.