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case_images: High ground path impedance of 9.64 kOmega at the time of neural responsive telemetry.
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case_images: The impedance recording indicated a high ground path impedance (GPI) of 9.64 kOmega with electrodes 3, 4, 5, 6, 7, 11, and 12 showing a short circuit symbol opposite to them (Figure 1). The NRT display suggested a short circuit of the electrodes (Figure 1), which can be attributed to suctioning of the perilymph from the labyrinth and around the electrodes; however, this does not explain the reason for the high impedance. When impedance readings could not be recorded and additional electrodes were short-circuited, the Med-EL engineer was consulted telephonically, and the photographs (Figures 1-3) were shared with her.
case_images: Unrecordable ground path impedance at 0 kOmega after a few minutes and increase in the number of short circuit electrodes.
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case_images: When impedance readings could not be recorded and additional electrodes were short-circuited, the Med-EL engineer was consulted telephonically, and the photographs (Figures 1-3) were shared with her.
case_images: Unrecordable evoked compound action potential at the time of neural responsive telemetry.
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case_images: When impedance readings could not be recorded and additional electrodes were short-circuited, the Med-EL engineer was consulted telephonically, and the photographs (Figures 1-3) were shared with her.
case_images: Injecting saline between the periosteal flap and the ground electrode of the cochlear implant.
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case_images: She suggested 2 possible reasons for the high impedance: (i) tight sutures overlapping the ground electrode in the receiver-stimulator complex [There were no overlapping sutures (Figure 4)] or (ii) dryness of the periosteal flap over the ground electrode.
case_images: Ideal ground path impedance (less than 1.5 kOmega) and neural responsive telemetry following saline instillation.
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case_images: Neural responsive telemetry and ECAP were recordable in all 12 electrodes, as shown in Figures 5 and 6.
case_images: Recordable evoked compound action potential following saline instillation.
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case_images: Neural responsive telemetry and ECAP were recordable in all 12 electrodes, as shown in Figures 5 and 6.
case_images: Normal neural responsive telemetry in the postoperative period during "switch on" of the implant.
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case_images: The normal NRT and GPI recorded during that time is shown in Figure 7.