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

Pau, Hans Wilhelm; Ehrt, Karsten; Just, Tino; Sievert, Uwe; Dahl, Rüdiger

doi:10.1017/s0022215110002392

Cited by 16 publications

(14 citation statements)

References 13 publications

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“…Therefore, fitting methods based on objectively measured parameters have been sought. Different researchers tried to use electrically-evoked auditory brainstem responses, electrically-evoked stapedius reflex thresholds or measurements of the electrically-evoked compound action potentials (ECAP) [Mittal and Panwar, 2009;Muhaimeed et al, 2010;Pau et al, 2011;Van Den Abbeele et al, 2012]. Even though the correlations of these measures with the behavioural thresholds (T levels) and hearing comfort levels (C levels) are relatively weak [Holstad et al, 2009;Potts et al, 2007;Smoorenburg et al, 2002;Tao et al, 2011] for particular electrodes, fittings based on the objective profiles with subsequent behavioural adaptation of the 'shift and tilt' [Hughes et al, 2001;King et al, 2006;Smoorenburg et al, 2002] are widely used and currently rank among the best available options.…”

Section: Introductionmentioning

confidence: 99%

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

Molisz

Zarowski²,

Vermeiren³

et al. 2015

Audiol Neurotol

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Objective: To evaluate the postoperative changes of the basic electrophysiological and psychophysical parameters in cochlear implant (CI) patients: the impedance of the electrode contacts, the electrically-evoked compound action potential (ECAP) thresholds and the T/C levels. Study Design and Setting: Retrospective case review in a quaternary otologic referral centre. Materials and Methods: Data on the impedance of the electrode contacts, the ECAP thresholds and the T/C levels were collected in 20 consecutive CI patients divided into 2 groups. Group 1 comprised 10 prelingually deaf children implanted before the age of 18 months, and group 2 comprised 10 postlingually deaf adults (average age of 58 years). All patients were users of the Nucleus 24RECA (Freedom, Contour advance off-stylet electrode) CI. Results and Conclusions: (1) The mid-portion and the apical electrodes showed a decrease in the impedance values between the 1st and the 6th postoperative months and stabilization in the later course. Impedance of the most basal electrodes grew during the first postoperative months and stabilized later on, but remained higher than the impedance of the mid-portion and the apical electrodes. (2) The neural response telemetry threshold values tended to decrease within the first 3 months after surgery to reach a plateau afterwards. (3) The behavioural threshold levels remained generally stable, except for the basal electrodes where a decrease could be observed. The hearing comfort levels showed an increase during the first 6 months of the implant use and remained stable afterwards.

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Section: Introductionmentioning

confidence: 99%

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

Molisz

Zarowski²,

Vermeiren³

et al. 2015

Audiol Neurotol

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“…Another possibility for the child population would be visual intraoperative assessment of the stapedius reflex, a simple, fast, and objective procedure. Even though intraoperative ESRT was higher than postoperative values, possibly due to the action of anesthetic agents that can weaken the stapedius reflex muscle during surgery (Ruth et al, 1982;Gnadeberg et al, 1994;Pau et al, 2011), this procedure provides important information both at the time of surgery and postoperative activation of the CI (Baysal et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Electrically evoked stapedius reflex thresholds (ESRT) are promising, given that the research has shown a relationship between these thresholds and the maximum comfort level in adults and children with CI (Stephan and Welzl-Müller, 2000). The ESRT can be obtained easily in the clinic, using standard immittance measurement instrumentation, or intraoperatively, via direct observation or immittance measurements (Pau et al, 2011). It can be recorded for a majority of patients (Hodges et al, 1999;Gordon et al, 2004;Van Den Abbeele et al, 2012) and generally lies around the comfort level, thus below the uncomfortable level (Jerger et al, 1988;Hodges et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…[11] ESR is a quick and non-invasive method to verify the integrity of auditory nerve functions. [12] ESR thresholds could be used to extract useful information, as several studies have indicated an association between these thresholds and the assessment of maximum comfort level (C-level) in adults and children with CIs. [13][14][15][16] The correlation between the values obtained objectively and values assessed by the behavioral method has been extensively investigated.…”

Section: Original Articlementioning

confidence: 99%

Untitled

Bayat¹

2018

AJP

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Objective: The present study aimed to compare neural response telemetry (NRT) and electrical stapedius reflex (ESR) with behavioral thresholds in pre-and post-lingual cochlear implant (CI) recipients. Materials and Methods: A total of 30 patients (15 males and 15 females) aged 3-40 years old were participated in this study. They were underwent CI operation at Khuzestan CI, Ahvaz, Iran, from March 2013 to August 2016. The NRT and ESR values were measured in all patients and compared with the respective behavioral threshold at the same time. Results: The NRT and ESR thresholds were determined successfully in all patients. The NRT thresholds showed significant correlation with the C-levels (r = 0.645, P < 0.001) and fell at 74.12% of the dynamic range of the map in children and at 85% in adults. Our data indicated that there was a strong correlation between the mean ESR and behavioral thresholds (C-levels) in children (r = 0.78, P = 0.004) and adults (r = 0.82, P < 0.001). The mean behavioral thresholds were identical between males and females (independent sample t-test, P > 0.05). In addition, both NRT and ESR showed no statistical difference between males and females (independent sample t-test, P > 0.05). Conclusion: Both ESR and NRT thresholds showed strong correlation with the respective behavioral thresholds; however, the ESR threshold may be a better predictor of C-levels values compared with the NRT thresholds.

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

Cited by 16 publications

References 13 publications

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

Postimplantation Changes of Electrophysiological Parameters in Patients with Cochlear Implants

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

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