title: Effect of cochlear implant electrode insertion on middle-ear function as measured by intra-operative laser Doppler vibrometry.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of cochlear implant electrode insertion on middle-ear low frequency function in humans.
  
  
  BACKGROUND
  Preservation of residual low frequency hearing with addition of electrical speech processing can improve the speech perception abilities and hearing in noise of cochlear implant users. Preservation of low frequency hearing requires an intact middle-ear conductive mechanism in addition to intact inner-ear mechanisms. Little is known about the effect of a cochlear implant electrode on middle-ear function.
  
  
  METHODS
  Stapes displacement was measured in seven patients undergoing cochlear implantation. Measurements were carried out intra-operatively before and after electrode insertion. Each patient acted as his or her own control. Sound was delivered into the external auditory canal via a speaker and calibrated via a probe microphone. The speaker and probe microphone were integrated into an individually custom-made ear mould. Ossicular displacement in response to a multisine stimulus at 80 dB SPL was measured at the incudostapedial joint via the posterior tympanotomy, using an operating microscope mounted laser Doppler vibrometry system.
  
  
  RESULTS
  Insertion of a cochlear implant electrode into the scala tympani had a variable effect on stapes displacement. In three patients, there was little change in stapes displacement following electrode insertion. In two patients, there was a significant increase, while in a further two there was a significant reduction in stapes displacement. This variability may reflect alteration of cochlear impedance, possibly due to differing loss of perilymph associated with the electrode insertion.
  
  
  CONCLUSIONS
  Insertion of a cochlear implant electrode produces a change in stapes displacement at low frequencies, which may have an effect on residual low frequency hearing thresholds.
authors.affiliation: Auditory Implantation Unit, Department of Otolaryngology, Head and Neck Surgery, Guy's and St Thomas' Hospitals, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Donnelly
authors.forename: A
authors.initials: A
authors.lastname: Bibas
authors.forename: D
authors.initials: D
authors.lastname: Jiang
authors.forename: D-E
authors.initials: DE
authors.lastname: Bamiou
authors.forename: C
authors.initials: C
authors.lastname: Santulli
authors.forename: G
authors.initials: G
authors.lastname: Jeronimidis
authors.forename: A
authors.initials: A
authors.lastname: Fitzgerald O'Connor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants / Q000009:adverse effects*; D004432:Ear, Middle / Q000503:physiopathology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011312:Pressure / Q000009:adverse effects*; D013199:Stapes / Q000033:anatomy & histology / Q000502:physiology*; D055815:Young Adult