ELECTROPHYSIOLOGICAL TESTING AND X-RAY SKULL TRANSORBITAL VIEW: BETTER MODALITY TO ASSESS COCHLEAR IMPLANT ELECTRODE POSITION

Abstract

Background: Cochlear implantation is a revolutionary treatment for sensorineural hearing loss; however, precise positioning of the cochlear implant electrode within the cochlea remains a critical predictor of postoperative outcomes.

Objectives: Therefore, this study compared electrophysiological testing and transorbital cranium X-rays for assessing the position of electrodes within the cochlea in order to determine electrode position.

Study Design: Cross-sectional

Place and Duration: From February 2022 to July 2023, this comparative cross-sectional study was conducted at Combined Military Hospital in Rawalpindi, Pakistan.

Methods: Study comprised twenty patients who underwent cochlear implant surgery with modiolar electrodes. Patients' demographics, and clinical characteristics were collected. Electrophysiological testing with ECAPs and impedance telemetry, and radiographic evaluation with transorbital cranium X-rays comprised the postoperative evaluations.

Results: Our findings revealed a complex relationship between electrophysiological and radiographic evaluations. In spite of the fact that all instances of incorrect electrode placement detected by X-ray were associated with aberrant electrophysiological results, there were notable deviations in certain instances. In one patient group (Group A), a strong correlation between the two methods was observed (p<0.05), whereas in another (Group B), the correlation was substantially weaker (p>0.05).

Conclusion: Electrophysiological testing and transorbital cranium X-rays cannot be relied upon solely to determine the proper placement of cochlear implant electrodes. The research highlighted the need for a multimodal strategy encompassing both methods bearing implications for enhancing cochlear implant outcomes.