OBJECTIVE: To describe a technique enabling the intraoperative assessment of the mechanical coupling of active middle ear implants in patients with normal or dysfunctional middle ears. PATIENTS: Patients with sensorineural or mixed hearing loss subjected to revision surgery of an active middle ear implant. INTERVENTION: Recording of compound action potentials (CAPs) of the auditory nerve in response to stimulation via an active middle ear implant during revision surgery. MAIN OUTCOME MEASURES: CAP thresholds as a measure of mechanical coupling and system integrity. CONCLUSION: Determining CAP thresholds may be suitable for identifying a proper mechanical coupling of active middle ear implants in patients with a dysfunctional middle ear, even if the ossicular chain is disrupted.
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