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Dr Herbert Silverstein of the Ear Research Foundation, Sarasota, Fla, presented his experience with the preservation of hearing by direct monitoring of the eighth cranial nerve in cerebellopontine angle surgery at the "Second International Symposium on Surgery of the Inner Ear" last August in Aspen, Colo. He emphasized that this should presently be considered strictly a research tool. Dr Silverstein uses bilateral lucite ear molds to provide control data from the contralateral ear. He uses a silver electrode with a cotton tip, which is placed directly on the cochlear nerve. Intraoperative latency shifts of less than 0.3 m/s have correlated with postoperative hearing levels within 15 dB of preoperative levels for retrolabyrinthine procedures. However, for retrosigmoid approaches to the internal auditory canal, the cochlear nerve appears to be much more sensitive.
The important difference between direct stimulation of the eighth cranial nerve and electrocochleography is that in direct stimulation the
LEVINE T. Direct Monitoring of the Cochlear Nerve in Cerebellopontine Angle Surgery and Endolymphatic Surgery in the Treatment of Meniere's Disease. Arch Otolaryngol Head Neck Surg. 1987;113(2):123. doi:10.1001/archotol.1987.01860020013002
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