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Abstract

Medicine

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process

Published: June 21st, 2024

DOI:

10.3791/66526

1Department for Hearing, Speech and Voice Disorders, Tirol-Kliniken GmbH, 2Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, 3Department of Otorhinolaryngology, Medical University Innsbruck, 4Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technical University of Dresden

Abstract

Measuring the electrically evoked stapedius reflex during the fitting of cochlear implants (CIs) provides a reliable estimation of maximum comfort levels, resulting in the programming of the CI with high hearing comfort and good speech understanding. Detection of the stapedius reflex and the required stimulation level on each implant channel is already being performed during surgery, whereby intraoperative stapedius reflexes are observed through the surgical microscope. Intraoperative stapedius reflex detection is both an indicator that the auditory nerve is responding to electrical stimulation up to the brainstem and a test for the ability to perform postoperative stapedius reflex measurements. Postoperative stapedius reflex thresholds can be used to estimate upper stimulation levels in the CI fitting process. In particular, in children or patients unable to provide feedback on loudness perception, this method avoids inadequate stimulation with the CI, which can result in poor hearing performance. In addition, overstimulation can be avoided, which could even lead to refusal to use the device.

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