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Conventional and remote intraoperative NRT measurements
Hülya Göçmenler1, Şengül Terlemez2, Ayça Çiprut3, Ferda Akdaş41Department of Audiology, Istanbul Medeniyet University, Faculty of Health Sciences, Istanbul, Turkey2Department of Audiology, Istanbul Aydin University, Faculty of Health Sciences, Istanbul, Turkey
3Department of Audiology, Marmara University, Faculty of Medicine, Istanbul, Turkey
4Retired, Department of Audiology, Marmara University, Faculty of Medicine, Istanbul, Turkey
INTRODUCTION: The aim of this study was to establish the reliability of evoked compound action potential (ECAP) thresholds obtained using the conventional AutoNRT programming system and the CR220 Intraoperative Remote Assistant. Another objective was to compare intraoperative NRT thresholds with postoperative thresholds.
METHODS: Nineteen patients who received a Nucleus CI24RE or CI422 cochlear implant for severe-to-profound hearing loss were included in the study. The patients’ ages ranged from 13 months to 15 years, with a mean age of 4 years. Intraoperative NRT thresholds were measured on all functioning electrodes using both the conventional AutoNRT programming system and the CR220 Intraoperative Remote Assistant. Postoperative ECAP thresholds were obtained 4–6 weeks after surgery using the conventional AutoNRT system and were compared with the intraoperative measurements.
RESULTS: NRT thresholds showed no statistically significant differences between the conventional and remote conditions for any electrode, except E20 (p=0.027). Intraoperative NRT thresholds were also compared with postoperative AutoNRT thresholds for five representative electrodes (E1, E6, E11, E16, and E22); a statistically significant difference was observed only for E22 (p=0.015), while no significant differences were found for the remaining electrodes.
DISCUSSION AND CONCLUSION: The CR220 Intraoperative Remote Assistant provides reliable NRT thresholds. There were no statistically significant differences between the NRT thresholds obtained using the CR220 and those obtained using the conventional AutoNRT method. Although newer intraoperative platforms, such as SmartNav, have recently emerged, the CR220 Remote Assistant is still used in many centers worldwide and remains an essential tool in clinical settings where newer systems are not yet accessible. Therefore, establishing its reliability relative to AutoNRT continues to have clinical value, particularly for pediatric cochlear implant candidates and institutions interpreting large volumes of historical intraoperative NRT data.
Keywords: AutoNRT, cochlear implant, CR220 Remote Assistant, ECAP.
Manuscript Language: English
