Electrocochleogram after transection of vestibulo-cochlear nerve in a patient with a large acoustic neurinoma.
This study reports pre- and post-operative compound action potentials (CAPs) that were recorded from a 27-year-old woman with an acoustic neurinoma. During surgery it was necessary to totally sever her vestibulo-cochlear nerve to excise a large tumor. A pure tone audiogram changed to the scale-out pattern immediately after operation. However, CAP, the waveform of which was broadened, has been recorded 3 years post-operatively with a threshold elevation of 10 dB over the pre-operative threshold. This phenomenon suggests that CAP may originate from the extreme periphery of the auditory nerve within the cochlea. The broadening of the CAP was assumed to result from enhancement of the negative summating potential included in the CAP. We studied the effect of preceding stimulus on CAP using paired click stimuli pre- and post-operatively. A reduction of CAP amplitude in response to the second click of paired clicks was markedly suppressed in the inter-click interval between 3 and 80 ms post-operatively. We speculate that depletion of adaptation induced the abnormal CAP recovery described above and that the lateral efferent nerve system was involved in abnormal CAP adaptation with transection of the vestibulo-cochlear nerve in this case.
Ohashi
T
T
Department of Otorhinolaryngology, School of Medicine, St. Marianna University, Yokohama City Seibu Hospital, Japan.
Ochi
K
K
Kinoshita
H
H
Kenmochi
M
M
Kikuchi
H
H
Nishino
H
H
Taguchi
Y
Y
D000200:Action Potentials; D000328:Adult; D001300:Audiometry, Evoked Response; D001309:Auditory Threshold; D003056:Cochlear Nerve / Q000601:surgery; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009464:Neuroma, Acoustic / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors; D014725:Vestibular Nerve / Q000601:surgery