Relationship of intraoperative and postoperative electrically evoked stapedius reflex threshold and comfort level in cochlear implant patients

2004 ◽  
Vol 5 (S1) ◽  
pp. 32-33 ◽  
Author(s):  
Tatsuhito Owa ◽  
Akira Ganaha ◽  
Masaharu Ura ◽  
Tetsuya Tono
Keyword(s):  
Cochlear Implant ◽  
Comfort Level ◽  
Stapedius Reflex ◽  
Reflex Threshold ◽  
Relationship Of

The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant

2018 ◽  
Vol 29 (04) ◽  
pp. 292-299 ◽  
Author(s):  
Kelly Cristina Lira de Andrade ◽  
Lilian Ferreira Muniz ◽  
Pedro de Lemos Menezes ◽  
Silvio da Silva Caldas Neto ◽  
Aline Tenório Lins Carnaúba ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Case Series ◽  
Comfort Level ◽  
Small Children ◽  
Case Series Study ◽  
Significant Difference ◽  
Stapedius Reflex ◽  
Reflex Threshold ◽  
Maximum Comfort

AbstractOne of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.Cross-sectional analytical observational case series study.We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer’s software (custom sound Ep 3–2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey’s honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov–Smirnov test examined whether significant relationships existed between these other factors.The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.

scholarly journals Correlation between behaviorally measured comfort (c) levels and electrically evoked stapedius reflex thresholds (ESRT) in children with unilateral cochlear implant

2019 ◽  
Vol 11 (4) ◽  
pp. 201-206
Author(s):  
Roshani Mishra ◽  
Aparna Nandurkar
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
Acoustic Stimulation ◽  
Comfort Level ◽  
Clear Cut ◽  
Significant Difference ◽  
Stapedius Reflex

Introduction: Decrease in the lower age limit for paediatric cochlear implantation and increasing records of cochlear implantation in children with associated impairments demand quick and easily available objective measurements to provide MAP in these children as their speech and language ability may not be adequate to provide clear cut explanation about comfort level. Providing adequate amount of acoustic stimulation in this golden period of life (i.e. 0-2 years) is important in ensuring the proper utilization of acoustic cues. Findings of adult population cannot be directly applied to younger children and till date there is no Indian study reporting relationship between Electrically Evoked Stapedial Reflex Thresholds (ESRT) and behavioural Comfort levels, especially in pediatric population. Aim: The present study aimed to assess the correlation between behaviorally measured comfort (C) levels and Electrically Evoked Stapedius Reflex Thresholds (ESRT) in children with unilateral cochlear implant. Method: Children (n=40) with age range of 4-12 years, who received the same type of CI and electrode configuration, were selected for the study. Participants were divided into two groups – younger and older - based on their chronological age. Behavioural C-level measurement and ESRT measurement were done after tympanometry for both the groups. Correlation between the two measures was obtained and comparison between the two groups was done. Results and discussion: Recorded ESRT was consistently higher than the behaviorally obtained C-level for both the groups. The correlation between ESRT and C-level varies from moderate to very strong and strong to very strong for the younger and older groups respectively. No statistically significant difference was found between the correlations for the two age groups. Conclusions: High correlations were found between the ESRT and behaviorally obtained C-levels. Thus ESRT can be utilized as a tool for programming in younger implant recipients.

Stapedius Reflex in Patients with an Inner Ear Prosthesis

1992 ◽  
Vol 15 (7) ◽  
pp. 436-439 ◽  
Author(s):  
K. Stephan ◽  
K. Welzl-Muller
Keyword(s):  
Electrical Stimulation ◽  
Cochlear Implant ◽  
Inner Ear ◽  
Time Course ◽  
Temporal Integration ◽  
Fast Response ◽  
Acoustic Stimulation ◽  
Acoustic Reflex ◽  
Stapedius Reflex ◽  
Reflex Threshold

The stapedius reflex elicited by electrical stimulation was investigated in 21 deaf individuals supplied with an inner ear prosthesis. All patients were implanted with the Vienna cochlear implant using intra or extracochlear electrodes. Analog stimulation with sinus bursts of various durations (25, 50, 100, 300, 500 ms) and frequencies (125, 500, 1000, 2000 Hz) was used. The time course of the contralateral acoustic reflex was monitored using a fast-response impedance meter. The stapedius reflex was observed in about half of the cases. Reflex threshold was observed at a stimulation level close to uncomfortable loudness. The time course in case of electrical stimulation differs in some aspects (rise time, onset) from acoustic stimulation in hearing individuals. Temporal integration of the stapedius reflex was observed also in case of electrostimulation through the cochlear implant.

How reliable is visual assessment of the electrically elicited stapedius reflex threshold during cochlear implant surgery, compared with tympanometry?

2010 ◽  
Vol 125 (3) ◽  
pp. 271-273 ◽  
Author(s):  
H W Pau ◽  
K Ehrt ◽  
T Just ◽  
U Sievert ◽  
R Dahl
Keyword(s):  
Cochlear Implant ◽  
Visual Assessment ◽  
Visual Observation ◽  
Threshold Values ◽  
Implant Surgery ◽  
Threshold Assessment ◽  
Measuring Techniques ◽  
Cochlear Implant Surgery ◽  
Stapedius Reflex ◽  
Reflex Threshold

AbstractObjectives:To assess the reliability of visually assessed thresholds of the electrically elicited stapedius reflex, recorded during cochlear implant surgery, compared with intra-operative tympanometric threshold assessment. Intra-operatively recorded electrically elicited stapedius reflex thresholds vary considerably, and differ from those measured post-operatively by means of impedance changes (i.e. using tympanometry). Thus, any confounding effect of different intra-operative techniques and visual assessment inaccuracies should be excluded.Methods:Both techniques (i.e. visual observation and tympanometry) were performed intra-operatively in six patients, and threshold values were compared.Results:Recorded electrically elicited stapedius reflex thresholds were very similar for both techniques. Visually assessed thresholds were slightly higher in some cases and lower in others, compared with tympanometric thresholds.Discussion:There was almost no difference between reflex thresholds measured with the two different techniques under the same intra-operative conditions. Therefore, we conclude that differences between intra- and post-operative thresholds are not due to the use of different measuring techniques. The main reason for such differences is probably the influence of intra-operative narcotics on reflex thresholds.

Stapedius Reflex Threshold in Cochlear Implant Patients

1988 ◽  
Vol 27 (4) ◽  
pp. 227-233 ◽  
Author(s):  
K. Stephan ◽  
K. Welzl-müller ◽  
H. Stiglbrunner
Keyword(s):  
Cochlear Implant ◽  
Stapedius Reflex ◽  
Reflex Threshold

Optimizations for the Electrically-Evoked Stapedial Reflex Threshold Measurement in Cochlear Implant Recipients

2017 ◽  
Vol 38 (2) ◽  
pp. 255-261 ◽  
Author(s):  
Jace Wolfe ◽  
Melanie Gilbert ◽  
Erin Schafer ◽  
Leonid M. Litvak ◽  
Anthony J. Spahr ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Stapedial Reflex ◽  
Reflex Threshold ◽  
Threshold Measurement

Influence of EEG monitoring on intraoperative stapedius reflex threshold values in cochlear implantation in children

2003 ◽  
Vol 13 (9) ◽  
pp. 790-796 ◽  
Author(s):  
B. Schultz ◽  
F.A. Beger ◽  
B.P. Weber ◽  
O. Niclaus ◽  
E. Lullwitz ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Eeg Monitoring ◽  
Threshold Values ◽  
Stapedius Reflex ◽  
Reflex Threshold

Prediction of Dynamic Range from Stapedius Reflex in Cochlear Implant Patients

1988 ◽  
Vol 9 (1) ◽  
pp. 4-8 ◽  
Author(s):  
James Jerger ◽  
Terrey A. Oliver ◽  
Rose A. Chmiel
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Stapedius Reflex
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