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. 2020 May/Jun;41(3):465-475.
doi: 10.1097/AUD.0000000000000782.

Recommendations for Measuring the Electrically Evoked Compound Action Potential in Children With Cochlear Nerve Deficiency

Shuman He  1   2 , Xiuhua Chao  3 , Ruijie Wang  3 , Jianfen Luo  3 , Lei Xu  3 , Holly F B Teagle  4 , Lisa R Park  5 , Kevin D Brown  5 , Michelle Shannon  2 , Cynthia Warner  2 , Angela Pellittieri  1 , William J Riggs  1   2
Affiliations

Recommendations for Measuring the Electrically Evoked Compound Action Potential in Children With Cochlear Nerve Deficiency

Shuman He et al. Ear Hear. 2020 May/Jun.

Abstract

Objectives: This study reports a method for measuring the electrically evoked compound action potential (eCAP) in children with cochlear nerve deficiency (CND).

Design: This method was developed based on experience with 50 children with CND who were Cochlear Nucleus cochlear implant users.

Results: This method includes three recommended steps conducted with recommended stimulating and recording parameters: initial screen, pulse phase duration optimization, and eCAP threshold determination (i.e., identifying the lowest stimulation level that can evoke an eCAP). Compared with the manufacturer-default parameters, the recommended parameters used in this method yielded a higher success rate for measuring the eCAP in children with CND.

Conclusions: The eCAP can be measured successfully in children with CND using recommended parameters. This specific method is suitable for measuring the eCAP in children with CND in clinical settings. However, it is not suitable for intraoperative eCAP recordings due to the extensive testing time required.

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Conflict of interest statement

Conflict of Interest: Holly F.B. Teagle is a member of a Cochlear Corp. Audiology Advisory Board.

Figures

Figure 1.
Figure 1.
Traces evoked using different probe rates recorded at electrode 11 in CND3. All other stimulating and recording parameters used to measure these traces were the same. Subject number, the electrode location, the pulse phase duration (PPD) and the stimulation level used to evoke these traces are indicated in each panel. The upward and downward triangle indicate the trough and peak of the eCAP identified for the trace shown in panel (b).
Figure 2.
Figure 2.
Traces measured using different recording electrodes at electrode 9 in CND4. Stimulation levels used to evoke these traces are indicated in this figure. Subject number, the electrode location and the pulse phase duration (PPD) used to evoke these traces are indicated in each panel. The upward and downward triangles indicate the troughs and peaks of eCAPs identified for traces shown in panel (b).
Figure 3.
Figure 3.
Traces recorded at all 22 electrode locations in CND5 using different system gains and numbers of sweeps for the averaged response. Electrode number is indicated for each trace. Troughs and peaks of identified eCAPs in panel (c) are indicated using upward and downward triangles, respectively.
Figure 4.
Figure 4.
Traces recorded at ten electrode locations using three different settings in one child with CND. Each panel shows results recorded using on setting. Traces shown in panel (a) were elicited using a biphasic pulse with a pulse phase duration of 25 μs/phase. Black and dark grey dashed lines shown in panels (b) and (c) indicate traces evoked by a biphasic pulse with a pulse phase duration of 50 μs/phase and a biphasic pulse with a pulse phase duration of 75 μs/phase, respectively. Electrode number and stimulation level (in CL) are indicated for each trace. Troughs and peaks of identified eCAPs are indicated using upward and downward triangles, respectively.
Figure 5.
Figure 5.
Traces recorded at all 22 electrode locations using two different settings in CND2. Electrode numbers are labelled for these traces in both panels. Troughs and peaks of identified eCAPs are indicated using upward and downward triangles, respectively. It should be pointed out that peaks of eCAPs recorded at electrodes 3 and 4 shown in panel (a) could not be accurately identified due to electrical artifact contamination. Therefore, they are not labelled.
Figure 6.
Figure 6.
A screen shot of a NRT series created in Custom Sound EP (v.5.1) with recommended parameters for initial screen.
Figure 7.
Figure 7.
Traces in response to the cathodic-leading (solid line) and the anodic-leading (dashed line) biphasic pulse recorded at electrode in CND6 (panel [a]) and at electrode 14 in CND7 (panel [b]). The pulse phase duration (PPD) and stimulation level (in CL) used to evoke these traces are indicated in each panel.
Figure 8.
Figure 8.
Traces in response to the cathodic-leading (solid line) and the anodic-leading (dashed line) biphasic pulse recorded at electrode 9 in CND8. The pulse phase duration (PPD) and stimulation level (in CL) used to evoke these traces are indicated in the lower right corner.
See this image and copyright information in PMC

References

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