- Original Article
- Open Access
The relationship between the electrical stapedial muscle reflex threshold and electrical and behavioral measures in cochlear implant patients
The Egyptian Journal of Otolaryngology volume 32, pages49–52(2016)
Programming of multichannel cochlear implants (CIs) requires subjective responses to a series of sophisticated psychophysical percepts. It is often difficult for young prelinguistically deaf children to provide adequate responses for device fitting. This is especially true in setting levels of maximum comfortable loudness, whereby failure to indicate growth of loudness may result in elevation of stimulus levels to the threshold of pain. The acoustic or stapedial muscle reflex has been used previously to provide objective confirmation of acoustic stimulation, and there have been attempts to use the reflex in hearing-aid fitting. It has also been suggested that electrically elicited middle-ear muscle reflexes [electrically evoked stapedial reflex threshold (ESRT)] may have applicability in confirming and quantifying electrical stimulation through a CI. To assess the relationship between ESRT characteristics and levels of loudness perception with CIs, determine the reliability of the response, and investigate the potential use of ESRT in CI programming, 26 prelinguistically deafened CI users were evaluated. Reflexes have also been attempted on 312 electrodes, with responses present in 213 (68.3%). Comfort levels predicted by subjective judgments were highly correlated with the ESRT in individuals with CI. ESRT provides an objective, accurate, and rapid method of estimating maximum comfortable loudness levels, which may be useful in the initial programming of young implant recipients.
American Academy of Audiology (AAA): Cochlear implants in children. Available at: http://www.audiology.org/resources/documentlibrary/Pages/CochlearChildren.aspx. [Last accessed on 2012 Dec 10].
Arisi E, Forti S, Pagani D, et al. Cochlear implantation in adolescents with prelinguistic deafness. Otolaryngol Head Neck Surg 2010; 142: 804–808.
Müller J, Brill S, Hagen R, Moeltner A, Brockmeier SJ, Stark T, et al. Clinical trial results with the MED-EL Fine Structure Processing coding strategy in experienced cochlear implant users. ORL J Otorhinolaryngol Relat Spec 2012; 74: 185–198.
Baysal E, Karatas E, Deniz M, Baglam T, Durucu C, Abidin Karatas Z, et al. Intra- and postoperative electrically evoked stapedius reflex thresholds in children with cochlear implants. Int J Pediatr Otorhinolaryngol 2012; 76: 649–652.
Kosaner J. Generating speech processor programmes for children using ESRT measurements. Cochl Impl Int 2010; 11: 20–24.
Jolly C, Mueller J, Helbig S, Usami S. New trends with cochlear implants. Otol Jpn 2010; 20: 239–246.
Hughes ML, Stille LJ. Psychophysical and physiological measures of electrical-field interaction in cochlear implants. J Acoust Soc Am 2009; 125: 247–260.
Alvarez I, de la Torre A, Sainz M, Roldán C, Schoesser H, Spitzer P. Using evoked compound action potentials to assess activation of electrodes and predict C-levels in the TEMPO+ Cochlear implant speech processor. Ear Hear 2010; 31: 134–145.
Jerger J, Jenkins H, Fifer R, Mecklenburg D. Stapedius reflex to electrical stimulation in a patient with a cochlear implant. Ann Otol Rhinol Laryngol 1986; 95: 151–157.
Walkowiak A, Lorens A, Polak M, Kostek B, Skarzynski H, Szkielkowska A, Skarzynski PH. Evoked stapedius reflex and compound action potential thresholds versus most comfortable loudness level: assessment of their relation for charge-based fitting strategies in implant users. ORL 2011; 73: 189–195.
Polak M, Hodges A, Balkany T. CAP, ESR and subjective levels for two different Nucleus 24 electrode arrays. Otol Neurotol 2005; 26: 639–645.
Osterne FJV, Felix F, Kós MI, Tomita S. The electrically elicited stapedius muscle reflex in children with cochlear implants. Int Arch Otorhinolaryngol 2013; 17: 27.
Stephan K, Welzl-Muller K, Stiglbrunner H. Acoustic reflex in patient with cochlear implants (analog stimulation). Am J Otol 1991; 12Suppl:48–51.
Spivak LG, Chute PM. The relationship between electrical acoustic reflex thresholds and behavioral comfort levels in children and adult cochlear implant patients. Ear Hear 1994; 15: 184–192.
Mo L, Chen X, L Sha. Electrically evoked stapedius reflex in post-cochlear implant patients. J Audiol Speech Pathol 2004; 14: 77–83.
Han, D-M, Chen, X-Q, Zhao, X-T, Kong, Y Li, Y-X, Liu, S, Mo L-Y Comparisons between neural response imaging thresholds, electrically evoked auditory reflex thresholds and most comfortable loudness levels in CII bionic ear users with HiResolution sound processing strategies. Acta Otolaryngol 2005; 125:732–735.
Conflicts of interest
About this article
Cite this article
Asal, S., Sobhy, O.A. & Nooman, M. The relationship between the electrical stapedial muscle reflex threshold and electrical and behavioral measures in cochlear implant patients. Egypt J Otolaryngol 32, 49–52 (2016). https://doi.org/10.4103/1012-5574.175848
- cochlear implants
- electrical and behavioral measures
- stapedial muscle reflex threshold