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Updated: Feb 24, 2026
Performing Intracochlear Electrocochleography During Cochlear Implantation
Published on: March 8, 2022
Using Electrically-evoked Compound Action Potentials to Estimate Perceptive Levels in Experienced Adult Cochlear
Charles-Alexandre Joly1, Vincent Péan, Ruben Hermann
1*INSERM 1028 †CNRS 5292, Lyon Neuroscience Research Center, IMPACT Team (Integrative, Multisensory, Perception, Action and Cognition), Bron cedex ‡Claude Bernard University of Lyon 1, Villeurbanne cedex §MED-EL Elektromedizinische Geraete Gesellschaft m.b.H, Sophia-Antipolis ||Department of Otorhinolaryngology, Edouard Herriot Hospital, Hospices Civils de Lyon ¶Faculté de Médecine, INSERM 1028 **Faculté de Médecine, CNRS 5292, Lyon Neuroscience Research Center, WAKING Team (Integrative Physiologye of Brain Arousal Systems) ††Audiology and Orofacial explorations, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon cedex, France.
Hypothesis:
The cochlear implant (CI) fitting level prediction accuracy of electrically-evoked compound action potential (ECAP) should be enhanced by the addition of demographic data in models.
Introduction:
No accurate automated fitting of CI based on ECAP has yet been proposed.
Methods:
We recorded ECAP in 45 adults who had been using MED-EL CIs for more than 11 months and collected the most comfortable loudness level (MCL) used for CI fitting (prog-MCL), perception thresholds (meas-THR), and MCL (meas-MCL) measured with the stimulation used for ECAP recording. Linear mixed models taking into account cochlear site factors were computed to explain prog-MCL, meas-MCL, and meas-THR.
Results:
Cochlear region and ECAP threshold were predictors of the three levels. In addition, significant predictors were the ECAP amplitude for the prog-MCL and the duration of deafness for the prog-MCL and the meas-THR. Estimations were more accurate for the meas-THR, then the meas-MCL, and finally the prog-MCL.
Conclusion:
These results show that 1) ECAP thresholds are more closely related to perception threshold than to comfort level, 2) predictions are more accurate when the inter-subject and cochlear regions variations are considered, and 3) differences between the stimulations used for ECAP recording and for CI fitting make it difficult to accurately predict the prog-MCL from the ECAP recording. Predicted prog-MCL could be used as bases for fitting but should be used with care to avoid any uncomfortable or painful stimulation.
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