Digital Live Imaging of intraoperative electrocochleography and hearing preservation during Cochlear Implantation

Introduction Intraoperative electrocochleography (ECochG) during cochlear implantation is a promising tool to preserve residual hearing. However, the time gap between insertion of the electrode and acoustic feedback from the audiologist to the surgeon causes delay. For the first time real-time visualization of intraoperative ECochG via digital microscope (ARRISCOPE​) directly to the surgeon using “picture-in-picture mode” was successfully performed.

Methods Intraoperative setting was preliminarily tested in the lab. 45 patients with residual hearing underwent cochlear implantation. Insertion time and residual hearing retention were determined intraoperatively, one day, 6 weeks, 4 and 7 months postoperatively and compared with a group of patients operated on without image-in-image technique.

Results Digital live visualization of intraoperative ECochG using image augmentation in a digital microscope (ARRISCOPE​) was successfully performed and enabled direct adaptation of the surgeon’s insertion behavior. Looking directly at the data resulted in a non-significant increase in insertion time (picture-in-picture versus without picture-in-picture). Residual hearing retention at 250 Hz was possible in 83% of the cases in the picture-in-picture technique (versus 75% without picture-in-picture).

Discussion This study is the first to describe digital visualization of intraoperative EcochG in real-time and shows new possibilities for preserving residual hearing in cochlear implantations. Our results show that augmentation of the intraoperative live imaging with electrical potentials can add to hearing preservation during cochlear implantation.

Stefan Hans1, Victoria D´heygere1, Moritz Meyer1, Laura Waschkies 1, Kristina Anton2, Horst Hessel 2, Armin Schneider3, Thomas Heiler3, Benedikt Höing1, Stephan Lang1, Diana Arweiler-Harbeck1; 1 Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen; 2 Cochlear Deutschland GmbH & Co. KG, Hannover; 3 Munich Surgical Imaging​, München

Publication History

Article published online:
24 May 2022