Intraoperative Neural Response Telemetry and Auditory Outcomes in Pediatric Cochlear Implantation

Abstract

Objective: To evaluate the relationship between intraoperative neural response telemetry (NRT) and postoperative auditory testing outcomes in children. Study Design: Retrospective study. Setting: Tertiary-care academic center. Methods: Children who underwent cochlear implantation using the Cochlear Corporation device between 2010 and 2019 were included. Associations of average NRT and the slope of amplitude with postoperative auditory outcomes including functional auditory measure Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and speech perception testing (consonant-nucleus-consonant [CNC], Pediatric AzBio [BABY BIO], Hearing In Noise Test [HINT], and Northwestern University Children's Perception of Speech [NU-CHIPS]), measured between 6 and 57 months after implantation, were assessed using Spearman's rank correlation (ρ). Results: Thirty-eight patients (19 female, 19 male) and 54 ears were included. The median age of implantation was 20.6 months (range 9.6 months to 10.6 years). Eight (21%) children had neurologic disorders such as stroke, epilepsy, cerebral palsy, and other causes. Thirteen (34%) children had connexin mutations. Average NRT was not significantly correlated with postoperative auditory outcomes (IT-MAIS [ρ = −0.08, p =.74], CNC [ρ = 0.19, p =.32], BABY BIO [ρ = 0.21, p =.29], HINT [ρ = 0.05, p =.83]) and NU-CHIPS (ρ = 0.21, p =.28). The average slopes of amplitude and comfort level were not strongly correlated with any auditory outcomes (p >.05). Conclusions: Intraoperative NRT was not correlated with any postoperative functional auditory outcomes. Patient counseling should include discussions that a subpar intraoperative cochlear response does not preclude favorable speech and auditory outcomes.