Hearing Loss, Cochlear Clinical Trial
Official title:
Evaluation of Intra and Post-operative Electrocochleography for the Monitoring of Residual Hearing
This trial is a pilot study to assess the feasibility of using Electrocochleography recorded
from a cochlear implant intra-operatively in real time to monitor the progress of its
insertion. Correlation between:
1. Observed changes in this signal during surgery and residual hearing loss
post-operatively and
2. Recordings of this signal post-operatively and actual pure tone audiometry results will
also be assessed.
Cochlear Implants (CIs) can provide deaf individuals the ability to hear. CIs are electronics
packages inserted into the cochlea (hearing organ). An external processor digitises sound and
transmits it to the implant. An electric stimulus from the implant mimics the change in
electrical potential normally caused by the movement of stereocilia in the cochlea when a
sound occurs. This change generates an impulse along the auditory nerve to the brain
resulting in perception of sound.
CIs are available in the UK to people who have profound hearing loss. The improvement of CI
technology means individuals with less significant losses, or profound losses at only some
pitches may now benefit from a CI over a hearing aid. Patients having useful residual hearing
has led to interest in better preserving that hearing during surgery. Thus allowing benefit
from traditional acoustic amplification in addition to electrical stimulation from the
implant.
The investigators propose recording a measurement via the implant during surgery and at
audiology appointments called a cochlear microphonic using a technique called
electrocochleography (ECochG). This is essentially recording the electrical signal generated
by the movement of hair cells in the cochlea in response to a sound. It is hypothesised that
reduction of this signal during implantation may correspond to cochlea damage occurring and
that with development this signal might be useful feedback for surgeons. The signal is known
to be correlated to actual hearing ability so a better understanding of this may allow us to
fit the acoustic amplification portion of implants in individuals who are unable to respond
reliably to a normal hearing test.
The purpose of this study is a pilot to assess the correlation between observed changes in
this signal during surgery and residual hearing loss post-operatively and the degree
correlation between recordings of this signal post-operatively and actual hearing test
results.
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