The difficulty of accurately determining residual hearing requires insertion to be as atraumatic as possible, thereby maximizing potential residual hearing. Real-time visualization of intraoperative electrocochleography (EcochG) potentials via picture-in-picture (PIP) mode in digital microscopes such as the RoboticScope (BHS®) provides direct feedback to the surgeon during cochlear implant electrode insertion, enabling atraumatic insertion. The aim of this prospective study was to assess the influence of intraoperative real-time visualization with different visualizations on the preservation of residual hearing. Further development of MAESTRO EcochG Software (MED-EL®) now offers the possibility of continous EcochG potential measurement during implantation. Two methods (graph and arrows) for visualizing EcochG potentials were provided to the surgeon and directly transmitted into the RoboticScope and digitally visualized. Subsequently, the residual hearing is directly audiometrically recorded intraoperatively. For follow-up, the development of residual hearing is monitored both subjectively at 1 day, 6 and 12 weeks postoperatively. Initial results show a good preservation of residual hearing. The individual workload of the surgeon varies depending on the visualization method. The arrow visualization appears to result in worse hearing performance than the graphs, even though the insertion time do not differ. EcochG is a good tool to monitor the insertion of the cochlear implant and maintain residual hearing. The visualization method seems to play a role in this. For the surgeon's workload, it is not important how accurate the information presented by the PIP technique is, the insertion time stays the same as long as there is a kind of monitoring.
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Eichler et al. (2024) studied this question.
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