Sm. Mason et al., PERIOPERATIVE ELECTRICAL AUDITORY BRAIN-STEM RESPONSE IN CANDIDATES FOR PEDIATRIC COCHLEAR IMPLANTATION, The American journal of otology, 18(4), 1997, pp. 466-471
Objective: The aim was to investigate the feasibility of recording the
electrical auditory brain stem response (EABR) evoked by electrical s
timulation at the promontory (Prom-EABR) as a tool to assist selection
of the ear for cochlear implantation in young children. Study Design:
The study group consisted of young children for whom the decision to
proceed with implantation with the Nucleus mini 22-channel cochlear im
plant (Cochlear (UK) Ltd., London, UK) had already been made. Setting:
The Prom-EABR was recorded after the children had been anesthetised,
but before the start of surgery. Patients: A group of 25 children (11
boys and 14 girls), whose age at implantation ranged from 2 years 11 m
onths to 6 years 8 months (mean age, 4 years 5 months), were investiga
ted. Intervention: Recordings of the Prom-EABR were used to determine
which ear would receive the cochlear implant, providing there were no
preexisting contraindications regarding selection of the ear. Main Out
come Measure: It has been suggested from earlier studies that the char
acteristics of the amplitude input/output (I/O) function of the EABR a
re related to neuronal survival. If the ear with the ''better'' I/O fu
nction is chosen for implantation, it might be expected that these chi
ldren will perform better on average than those in whom the ear has be
en selected at random. Results: Reliable recordings of the Prom-EABR w
ere achieved in 40 ears (80%) of the 50 ears in the study. In 20 of th
e 25 children the technique was actively employed for selection of the
ear for implantation. Conclusions: Recording of the Prom-EABR in the
operating theater is a viable technique. Future analysis of long-term
outcome measures of performance with the implant will confirm or dispu
te the benefit of ear selection using the Prom-EABR.