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Updated: May 31, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Intraoperative electrically evoked stapedius reflex thresholds in children undergone cochlear implantation: round
Erkan Karatas1, Murat Deniz Aud, Tekin Baglam
1Inonu University, Medical Faculty, Turgut Ozal Medicine Center, Otorhinololaryngology Dept. (KBB) Elazig Road, km. 11, 44280 Malatya, Turkey. erkaratas@yahoo.com
Insights
Round window (RW) cochlear implant surgery requires less electrical stimulation time and lower thresholds compared to the promontory approach. This study investigated electrically evoked stapedius reflex thresholds (ESRT) in pediatric CI patients.
Area of Science:
- Otolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Cochlear implant (CI) surgery aims to restore hearing in individuals with severe to profound hearing loss.
- Optimizing intraoperative electrical stimulation is crucial for effective CI outcomes.
- The round window (RW) and promontory cochleostomy are common surgical approaches for CI insertion.
Purpose of the Study:
- To compare the efficacy of electrical stimulation between the RW and promontory cochleostomy approaches in pediatric CI surgery.
- To evaluate intraoperative electrically evoked stapedius reflex thresholds (ESRT) for different electrode positions.
Main Methods:
- A cohort of 39 children undergoing CI surgery was analyzed.
- Surgical procedures included both RW and promontory cochleostomy approaches.
- ESRT were measured for electrodes 1, 3, 6, and 12 (E1, E3, E6, E12) intraoperatively.
Main Results:
- The duration for obtaining ESRT was significantly shorter in the RW group compared to the promontory group (p<0.05).
- ESRT measurements were recorded at lower thresholds in the RW group across multiple electrodes (E1, E3, E6: p<0.001; E12: p<0.05).
Conclusions:
- The RW approach facilitates more efficient electrical stimulation during CI surgery.
- Lower ESRT and shorter duration in the RW group suggest superior intraoperative electrical stimulation compared to the promontory approach.
- RW insertion is recommended for optimal electrical stimulation in cochlear implant procedures.
Objectives:
To study the best electrically stimulation in cochlear implant surgery with round window (RW) and Promontory cochleostomy approaches with electrically evoked stapedius reflex thresholds (ESRT) intraoperatively.
Methods:
Thirty-nine children underwent CI surgery were included for this study. The surgical procedures consisted of RW and Promontory cochleostomy. ESRT for each 1st, 3rd, 6th and 12th electrodes (E) were determined. Statistical evaluation was done for the comparison of the thresholds and duration times for both groups.
Results:
The duration times of ESRT for E1, E3, E6 and E12 electrodes was shorter in RW group compared with the Promontory group (p<0.05). The statistical evaluation of ESRT measurements of E1, E3, E6 found p<0.001 and E12 electrode p<0.05 in RW group. ESRT measurements were recorded at lower threshold in the RW group compared with the Promontory group.
Conclusion:
The duration of electrically stimulation thresholds were shorter in RW group. ESRT measurements were recorded at lower threshold in the RW group compared with the Promontory group. RW insertion offers best electrically stimulation relative to electrode insertion via a promontory cochleostomy.
