PromBERA: A preoperative eABR: An update: Objective promontory stimulation eABR test for measuring the integrity of the auditory nerve in prospective CI candidates

Abstract

Prior to cochlear implantation, audiological tests are performed to determine candidacy in subjects with a hearing loss. This is usually done by measuring the acoustic auditory brainstem response (ABR). Unfortunately, for some subjects, a reproducible ABR recording cannot be obtained, even at high acoustic levels. Having a healthy stimulating auditory nerve is required for cochlear implantation in order to benefit from the electrical pulses that are generated by the implant and to improve speech comprehension. In some subjects, this prerequisite cannot be measured using routine audiological tests. In this study, the feasibility of recording electrically evoked auditory brainstem responses (eABR) using a stimulating transtympanic electrode, placed on the round window niche, together with MED-EL clinical system is investigated. The results show that it is possible to record reproducible eABR measurements using PromBERA. The response was also confirmed with intraoperative eABR measurements that were stimulated using the implanted CI electrode array. Similarities between the intraoperative measurements and the preoperative recorded waveforms were observed. In summary, the integrity and excitability of the auditory nerve can be objectively measured using the PromBERA in subjects where standard clinical testing procedures are unable to provide the information required.