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Updated: Feb 12, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Clinically recorded cortical auditory evoked potentials from paediatric cochlear implant users fitted with
Julie Kosaner1, Bram Van Dun2, Ozgur Yigit3
1Meders Speech and Hearing Clinic, Meders İşitme ve Konuşma Merkezi, Söğütlüçeşme Caddesi: No 102, Kadıköy, İstanbul 34714, Turkey.
Insights
This study shows that cortical auditory evoked potential (CAEP) scores improve over time in paediatric cochlear implant (CI) users, indicating better access to soft sounds. These findings help clinicians assess CI effectiveness in children.
Area of Science:
- Audiology
- Neuroscience
- Pediatric Medicine
Background:
- Assessing soft sound audibility in pediatric cochlear implant (CI) users is crucial for development.
- Cortical auditory evoked potentials (CAEPs) offer an objective measure of auditory processing.
- MED-EL devices and the electrically elicited stapedius reflex threshold (eSRT) fitting method were used.
Purpose of the Study:
- To objectively evaluate soft sound access (55 dB SPL) in young MED-EL CI users.
- To track the presence and latency of CAEPs over time post-implantation.
- To compare CAEPs in CI users with those of normal-hearing peers.
Main Methods:
- Forty-five pre-lingually deafened pediatric MED-EL CI users (12-48 months) underwent monthly CAEP testing.
- CAEPs were recorded using speech tokens (/m/, /g/, /t/) at 55 dB SPL.
- Twenty age-matched normal-hearing children served as a control group.
Main Results:
- CAEP presence increased and P1 latency decreased significantly with post-implantation duration.
- CAEP scores improved significantly over time and were worse for the /m/ token.
- CI users consistently showed smaller CAEP scores compared to the normal-hearing group.
Conclusions:
- This study establishes initial typical ranges for CAEPs in pediatric MED-EL CI users.
- CAEPs can validate CI intervention effectiveness and identify suboptimal outcomes early.
- CAEPs provide a clinical method to verify soft sound access, potentially replacing behavioral measures.
Objectives:
This study aimed to objectively evaluate access to soft sounds (55 dB SPL) in paediatric CI users, all wearing MED-EL (Innsbruck, Austria) devices who were fitted with the objective electrically elicited stapedius reflex threshold (eSRT) fitting method, to track their cortical auditory evoked potential (CAEP) presence and latency, and to compare their CAEPs to those of normal-hearing peers.
Methods:
Forty-five unilaterally implanted, pre-lingually deafened MED-EL CI users, aged 12-48 months, underwent CAEP testing in the clinic at regular monthly intervals post switch-on. CAEPs were recorded in response to short speech tokens /m/, /g/ and /t/ presented in the free field at 55 dB SPL. Twenty children with normal hearing (NH), similarly aged, underwent CAEP testing once.
Results:
The proportion of present CAEPs increased and CAEP P1 latencies reduced significantly with post-implantation duration. CAEPs were scored based on their presence and age-appropriate P1 latency. These CAEP scores increased significantly with post-implantation duration. CAEP scores were significantly worse for the /m/ speech token compared to the other two tokens. Compared to the NH group, CAEP scores were significantly smaller for all post-implantation test intervals.
Conclusions:
This study provides clinicians with a first step towards typical ranges of CAEP presence, latency, and derived CAEP score over the first months of MED-EL CI use. CAEPs within these typical ranges could validate intervention whereas less than optimum CAEPs could prompt clinicians to seek solutions in a timely manner. CAEPs could clinically validate whether a CI provides adequate access to soft sounds. This approach could form an alternative to behavioural soft sound access verification.
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