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Evaluation of Three Intraoperative Auditory Monitoring Techniques in Acoustic Neuroma Surgery

Battista, Robert A.*; Wiet, Richard J.*; Paauwe, Lisa

The American Journal of Otology: March 2000 - Volume 21 - Issue 2 - p 244-248
Cranial Nerve Monitoring

Objective To assess the efficacy of three intraoperative auditory monitoring techniques: auditory brainstem response (ABR), electrocochleography (ECoG), and direct eight nerve monitoring (DENM).

Study Design A retrospective review of the intraoperative recordings of ABR, ECoG, and DENM was performed.

Setting A private, neurotologic practice.

Patients Sixty-six patients with usable preoperative hearing underwent intraoperative auditory monitoring with ABR, ECoG, or DENM.

Interventions Intraoperative auditory monitoring.

Main Outcome Measures Postoperative pure-tone hearing threshold and word recognition scores.

Results Of the 66 patients, 16 (24%) had postoperative serviceable hearing. Five (18%) of the 28 with ABR monitoring, 3 (17%) of the 18 with ECoG monitoring, and 8 (40%) of the 20 with DENM monitoring had serviceable hearing after surgery.

Conclusions This study suggests that DENM may be more effective than ABR or ECoG, although the differences in hearing preservation rates are not statistically significant.

*Department of Otolaryngology, Northwestern University Medical School, Chicago; and †Department of Neurophysiology and Sleep Disorders, Hinsdale Hospital, Hinsdale, Illinois, U.S.A.

Address correspondence to Dr. Robert A. Battista, Chicago Otology Group, 950 N. York Road, Suite 102, Hinsdale, Illinois 60521-8608, U.S.A.

© 2000 Lippincott Williams & Wilkins, Inc.