title: Intraoperative neural response telemetry as a predictor of performance.
abstract: OBJECTIVE
  To determine whether intraoperative neural response telemetry (tNRT) is predictive of postoperative speech perception.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Children (n = 24) aged between 5 and 17 years and adults 18 years and older (n = 73) with severe-to-profound hearing loss and implanted with the Nucleus Freedom device between 2005 and 2008 and observed at least 1 year were included.
  
  
  METHODS
  Intraoperative neural response telemetry after insertion of the electrode array.
  
  
  METHODS
  Measures included 1) intraoperative tNRT measurements and 2) preoperative and 1-year postoperative open-set word recognition scores using age-appropriate open-set tests for children and adults. Intraoperative neural response telemetry levels for electrodes E20, E15, E10, and E5 in each patient were correlated to performance at the 1-year evaluation interval.
  
  
  RESULTS
  No correlation existed between tNRT responses and open-set speech performance at the 1-year evaluation. Several patients had absent tNRT in the OR but developed speech recognition abilities, whereas the remaining patients had intraoperative responses with levels of postoperative performance ranging from 0% to 100%.
  
  
  CONCLUSIONS
  This study suggests that there is no significant correlation between intraoperative tNRT and speech perception performance at 1 year. At the time of surgery, tNRT provides valuable information regarding the electrical output of the implant and the response of the auditory system to electrical stimulation and preliminary device programming data; however, it is not a valuable predictor of postoperative performance. Furthermore, the absence of tNRT does not necessarily indicate a lack of stimulation.
authors.affiliation: Department of Otolaryngology, New York University Langone Medical Center, New York, New York 10016, U.S.A. maura.cosetti@nyumc.org
authors.forename: Maura K
authors.initials: MK
authors.lastname: Cosetti
authors.forename: William H
authors.initials: WH
authors.lastname: Shapiro
authors.forename: Janet E
authors.initials: JE
authors.lastname: Green
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Roman
authors.forename: Anil K
authors.initials: AK
authors.lastname: Lalwani
authors.forename: Stacey H
authors.initials: SH
authors.lastname: Gunn
authors.forename: John Thomas
authors.initials: JT
authors.lastname: Roland
authors.forename: Susan B
authors.initials: SB
authors.lastname: Waltzman
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods*; D003054:Cochlear Implants; D004558:Electric Stimulation; D004566:Electrodes; D004576:Electromyography; D005154:Facial Nerve / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology; D013067:Speech Perception / Q000502:physiology; D013686:Telemetry / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult