Electrically Evoked Auditory Brainstem Response Using Extracochlear Stimulation at Different Cochlear Sites: A Comparison With Intracochlear Stimulation.

Objectives: The distribution and extent of excitable spiral ganglion neurons (SGNs) have been investigated using the electrically evoked auditory brainstem response (EABR) during preoperative and perioperative periods. In this study, we investigated the EABR with extracochlear stimulation (eEABR) as a preoperative test to estimate these factors.

Methods: Sixteen male Sprague-Dawley rats were used in this study. Experiments were conducted in nine rats with normal hearing and seven rats that were partially deafened with ouabain treatment. Each experiment involved the following steps: extracochlear stimulating electrode placement at three different sites along the axis of the cochlea and eEABR recordings; cochleostomy and four-channel intracochlear array implantation, followed by EABR recordings with various electrode pair combinations; and after electrophysiological measurements, harvest of the cochleae for histopathological evaluation. The slope characteristics of the amplitude growth function measured from eEABR and EABR, frequency-specific auditory thresholds, and the density of SGNs were compared.

Results: Similar trends were observed in slope changes on different sites of stimulation with both types of stimulation in normal-hearing animals-specifically, a monotonically increasing slope with increasing distance between bipolar pairs. In addition, eEABR slopes showed significant correlations with EABR slopes when the expected cochlear regions of stimulation were similar in normal-hearing animals. In partially deaf animals, the auditory thresholds at several frequencies had a significant correlation with the eEABR slopes of each extracochlear electrode at the apical, middle, and basal cochlear positions. This indicated that increasing the regions of cochlear stimulation had a differential impact on eEABR slopes, depending on the neural conditions.

Conclusion: Our results indicated that eEABR slopes showed significant spatial correlations with the functionality of the auditory nerve. Therefore, eEABR tests at various cochlear positions might be used for estimating the extent of excitable SGNs in cochlear implant candidates prior to implantation.