Intraoperative Neural Response Telemetry and Neural Recovery
                    Function: a Comparative Study between Adults and Children

Carvalho, Bettina; Hamerschmidt, Rogerio; Wiemes, Gislaine

doi:10.1055/s-0034-1372509

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International Archives of Otorhinolaryngology

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Sumário

Original Research • Int. Arch. Otorhinolaryngol. 19 (1) • Jan-Mar 2015 • https://doi.org/10.1055/s-0034-1372509 copy

Intraoperative Neural Response Telemetry and Neural Recovery Function: a Comparative Study between Adults and Children

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction

Neural response telemetry (NRT) is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI) users, using the CI itself to elicit and record the answers. In addition, it can alsomeasure the recovery function of the auditory nerve (REC), that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children.

Objective

To compare the results of NRT and REC between adults and children undergoing CI surgery.

Methods

Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts) and REC as a function of three parameters: A (saturation level, in microvolts), t0 (absolute refractory period, in seconds), and tau (curve of the model function), measured in three electrodes (apical, medial, and basal).

Results

Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children), and 24 with REC (12 adults and 12 children). No statistically significant difference was found between intraoperative responses of adults and children for NRTor for REC's three parameters, except for parameter A of the basal electrode.

Conclusion

The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode.

telemetry; cochlear implants; deafness

Patient	Age (y)	Cause of deafness	Duration of deafness
1	39	Idiopathic	10 y
2	21	Congenital rubella	Lifetime
3	30	Idiopathic	11 y
4	26	Idiopathic	9 y
5	42	Congenital rubella	Lifetime
6	30	Idiopathic	10 y
7	22	Idiopathic	8 y
8	46	Idiopathic	12 y
9	31	Idiopathic	11 y
10	65	Idiopathic	12 y
11	24	Genetic	8 y
12	32	Congenital rubella	Lifetime
13	46	Meningitis	25 y
14	19	Idiopathic	8 y
15	34	Idiopathic	10 y
16	41	Idiopathic	11 y
17	69	Meniere syndrome	10 y
18	39	Idiopathic	9 y
19	83	Presbycusis	5 y
20	22	Idiopathic	8 y
21	37	Idiopathic	9 y
22	18	Idiopathic	8 y
23	51	Idiopathic	11 y
24	21	Idiopathic	9 y
25	46	Idiopathic	12 y
26	32	Idiopathic	11 y

Patient	Age	Cause of deafness	Duration of deafness
1	11 y	Idiopathic	Lifetime
2	1 y	Idiopathic	Lifetime
3	4 y	Idiopathic	Lifetime
4	1 y	Idiopathic	Lifetime
5	1 y	Idiopathic	Lifetime
6	4 y	Idiopathic	Lifetime
7	2 y	Idiopathic	Lifetime
8	4 y	Idiopathic	Lifetime
9	3 y	Genetic	Lifetime
10	9 y	Genetic	Lifetime
11	10 y	Idiopathic	Lifetime
12 (bilateral)	2 y	Genetic	Lifetime
13	3 y	Genetic	Lifetime
14 (bilateral)	2 y	Genetic	Lifetime
15	5 y	Idiopathic	Lifetime
16	5 y	Idiopathic	Lifetime
17	9 y	Idiopathic	Lifetime
18	2 y	Idiopathic	Lifetime
19	4 y	Meningitis	2 y
20	3 y	Idiopathic	Lifetime
21	5 y	Idiopathic	Lifetime
22	9 mo	Genetic	Lifetime
23	4 y	Encephalitis	1 y
24	8 y	Idiopathic	Lifetime

Patients	Age (y)	Cause of deafness	Duration of deafness (years)
1	41	Idiopathic	11
2	46	Idiopathic	12
3	46	Idiopathic	12
4	41	Otosclerosis	8
5	30	Idiopathic	10
6	39	Idiopathic	10
7	19	Idiopathic	8
8	39	Idiopathic	9
9	43	Otosclerosis	8 y
10	22	Idiopathic	8
11	24	Congenital rubella	Lifetime
12	30	Genetic	5 y

Patients	Age (y)	Cause of deafness	Duration of deafness
1	1	Genetic	Lifetime
2	2	Genetic	Lifetime
3	3	Idiopathic	Lifetime
4	13	Idiopathic	Lifetime
5	5	Idiopathic	Lifetime
6	2	Idiopathic	Lifetime
7	3	Idiopathic	Lifetime
8	1	Genetic	Lifetime
9	10	Idiopathic	Lifetime
10	3	Genetic	Lifetime
11	8	Idiopathic	Lifetime
12	2	Idiopathic	Lifetime

	Patients	n	Average current units
	Patients	n	Min–max	Average	SD	p value (t test)
Apical electrode	Adults	26	84–225	181.12	34.54	0.28
Apical electrode	Children	26	90–218	171.15	30.40
Medial electrode	Adults	26	146–236	191.69	18.56	0.51
Medial electrode	Children	26	112–225	195.54	22.69
Basal electrode	Adults	26	104–243	193.96	32.67	0.17
Basal electrode	Children	26	121–220	182.54	25.76

	Patients	n	Mean absolute refractory period (µs)
	Patients	n	Min–max	Average	SD	p value (Mann-Whitney test)
Apical electrode	Adults	12	184.43–1011.02	498.64	262.89	0.40
Apical electrode	Children	12	131.21–1667.18	527.28	409.29
Medial electrode	Adults	11	333.38–1040.90	636.06	252.93	0.44
Medial electrode	Children	12	270.38–1471.89	598.56	305.04
Basal electrode	Adults	12	31.97–770.51	477.99	225.74	0.20
Basal electrode	Children	12	73.59–666.89	428.20	171.34

	Patients	n	Mean saturation level (µV)
	Patients	n	Min–max	Average	SD	p value (Mann-Whitney test)
Apical electrode	Adults	12	13.72–229.84	101.50	68.35	0.27
Apical electrode	Children	12	26.37–278.98	136.50	93.22
Medial electrode	Adults	11	20.83–193.02	83.96	55.02	0.16
Medial electrode	Children	12	29.92–509.37	131.66	125.57
Basal electrode	Adults	12	16.17–216.40	57.07	53.46	0.02
Basal electrode	Children	12	38.41–146.25	76.98	34.35

	Patients	n	Curvature parameter of the model function (µs)
			Min–max	Average	SD	p value (Mann-Whitney test)
Apical electrode	Adults	12	16.60–1967.28	853.68	609.84	0.14
Apical electrode	Children	12	430.79–1856.67	1086.15	432.02
Medial electrode	Adults	11	24.43–1846.94	1073.66	653.96	0.14
Medial electrode	Children	12	1076.69–1956.13	1464.97	233.58
Basal electrode	Adults	12	11.64–1870.72	607.35	595.07	0.06
Basal electrode	Children	12	246.48–1623.40	929.38	516.12

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[1] Address for correspondence Prof. Dr. Rogério Hamerschmidt, MD, ENT Department, Instituto Paranaense de Otorrinolaringologia, Av Rep Argentina 2069, Curitiba 80620-010, Brazil (e-mail: bettinacarvalho@yahoo.com.br).