Comparison of automated and traditional ECAP recording approaches in clinical practice.

OBJECTIVE: The traditional method of recording electrically evoked compound action potentials (ECAPs), as implemented in the MAESTRO clinical software (standard ART), requires manual adjustments during threshold determination through a specialist. The "FineGrain" research tool (FineGrain RT) uses a continuous stimulation paradigm combined with automatic ECAP threshold determination. The aim of this study was to compare the FineGrain RT with standard ART. DESIGN: ECAPs were recorded with standard ART and the FineGrain RT in paediatric cochlear implant recipients. Different stimulation rates were used for FineGrain ECAP recordings (40, 60, and 76 Hz). STUDY SAMPLE: Thirteen children (6 - 19 years) participated in this study - nine were bilaterally and four unilaterally implanted, resulting in a total of twenty-two implanted ears. RESULTS: ECAP threshold determination success rates were similar between the two approaches (92% and 89%) and ECAP thresholds correlated well (r: 0.94, p < 2.2e-16) with average ART thresholds being lower than FineGrain RT thresholds. FineGrain stimulation with different stimulation rates did not have a significant effect on ECAP thresholds but ECAP thresholds at medial and apical contacts were lower compared to basal contacts. CONCLUSIONS: TheFineGrain research approach is a reliable replacement for standard ART in clinical practice.

Vibrant Soundbridge in congenital osseous atresia: multicenter study of 12 patients with osseous atresia.

CONCLUSION: The study suggests that the Vibrant Soundbridge (VSB) middle ear implant could be a valid alternative for patients with congenital aural atresia to compensate for their hearing loss. OBJECTIVE: To determine the audiologic benefit the VSB provides in patients with congenital aural atresia. METHODS: Twelve patients with congenital aural atresia were implanted with VSB: eight patients were unilaterally atretic (67%) and 4 (33%) were bilaterally atretic. In five cases the implant was placed onto the round window, in another five cases the implant was placed on the stapes, in only one case a prosthesis (coupler) was used to fix the implant into the oval window, and in one case a fenestration on the cochlear endostium was performed. RESULTS: The mean functional gain obtained for all patients evaluated was 62 dB at 0.5 kHz, 60 dB at 1 kHz, 48.3 dB at 2 kHz, and 50.8 dB at 4 kHz. The mean functional gain for all frequencies evaluated was 55.1 dB.