Neural response telemetry with the nucleus CI24M cochlear implant

Objectives: To review our intraoperative and postoperative testing protocol for cochlear implant patients. This study describes the methodologies and applications of a new technique called neural response telemetry (NRT) for the Nucleus CI24M cochlear implant system. NRT uses radiofrequency telemetr y technology to measure the action potentials of the auditory nerve. Study Design: We have developed a specific protocol for intraoperative testing of the implant device before, during, and after implantation. This includes d evice integrity tests, visual detection of electrical stapedius muscle refl exes (VESR), and NRT, Methods: Our methodologies use the commercial softwar e (Windows-based Diagnostic and Programming System [WIN-DPS] and NRT) for t he Nucleus CI24M. We describe the details of our protocol used on all of th e patients (14 adults and 14 children) who received CI24M implants at Mayo Clinic (Rochester, MN), Our protocol correlates the NRT threshold with the behavioral responses for each patient on at least four electrodes. Results: From August 1, 1998, to December 31,1998, we completed electrode integrity tests, NRT, and VESR testing intraoperatively on 12 patients with the Nucl eus CI24M. We have measured normal implant function on all 28 of our CI24M patients with one exception. One of our children had a device failure after approximately 4 months as a result of head trauma We have also obtained NR T results from an additional 10 patients postoperatively, Conclusions: The measurement of device and electrode array function is quite simple with the CI24M software. These measurements can be obtained intraoperatively as wel l as postoperatively, We conclude that VESR and NRT measurements can be ver y helpful in programming for patients with cochlear implants, especially ch ildren, because they provides us with target settings for the speech proces sor.