The role of the promontory stimulation test in cochlear implantation

To date, 290 adults have been implanted in the cochlear implant programme in Sydney (Australia), where the promontory stimulation test (PST) is routinely used to assess implant candidacy. There has been much controversy over the exact role and value of this test. Pre- and postoperative speech comprehension tests of 150 implantees were analysed, and scores were compared with preoperative PST performances. Eighty-nine per cent of the patients perceived sound when the promontory was stimulated electrically. This group of implantees scored 81% on CID speech tests at 12 months postoperatively, compared to the minority who lacked preoperative promontory stimulability, who scored 42%. The PST is therefore predictive of greater speech benefits after implantation. It also provides an important psychophysical experience of hearing electrical sound.