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Updated: Jun 17, 2026

Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
Comparison of in-situ calibration methods for quantifying input to the middle ear
James D Lewis1, Ryan W McCreery, Stephen T Neely
1Boys Town National Research Hospital, 555 North 30th Street, Omaha, Nebraska 68131, USA. james-lewis@uiowa.edu
Abstract:
Sound pressure level in-situ measurements are sensitive to standing-wave pressure minima and have the potential to result in over-amplification with risk to residual hearing in hearing-aid fittings. Forward pressure level (FPL) quantifies the pressure traveling toward the tympanic membrane and may be a potential solution as it is insensitive to ear-canal pressure minima. Derivation of FPL is dependent on a Thevenin-equivalent source calibration technique yielding source pressure and impedance. This technique is found to accurately decompose cavity pressure into incident and reflected components in both a hard-walled test cavity and in the human ear canal through the derivation of a second sound-level measure termed integrated pressure level (IPL). IPL is quantified by the sum of incident and reflected pressure amplitudes. FPL and IPL were both investigated as measures of sound-level entering the middle ear. FPL may be a better measure of middle-ear input because IPL is more dependent on middle-ear reflectance and ear-canal conductance. The use of FPL in hearing-aid applications is expected to provide an accurate means of quantifying high-frequency amplification.
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