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Updated: Feb 9, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
P1 cortical auditory evoked potential in children with unilateral or bilateral cochlear implants; implication for the
Sung Wook Jeong1, Seung Hyun Chung1, Lee-Suk Kim2
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Dong-A University, 3-1 Dongdaeshin-dong, Seo-gu, Busan, 602-715, South Korea.
Insights
Longer use of cochlear implants (CI) in children is linked to improved central auditory pathway maturation, indicated by shorter P1 cortical auditory evoked potential (CAEP) latency. Early auditory experience with the first implant may enhance outcomes with a second CI.
Area of Science:
- Neuroscience
- Audiology
- Developmental Pediatrics
Background:
- Central auditory pathway maturation is crucial for auditory development in children.
- Cochlear implantation (CI) is a common intervention for congenital or prelingual deafness.
- Understanding the impact of CI on auditory pathway development is essential for optimizing rehabilitation.
Purpose of the Study:
- To investigate the maturation of the central auditory pathway in children using P1 cortical auditory evoked potential (CAEP).
- To examine the effects of unilateral and bilateral cochlear implantation (CI) on P1 CAEP latency and maturation.
- To correlate CI duration and age at implantation with P1 CAEP measures.
Main Methods:
- Prospective study conducted at a tertiary referral hospital.
- Twenty children with congenital or prelingual deafness received either unilateral or bilateral CI.
- P1 CAEP was recorded after the first CI and, for bilateral cases, after the second CI.
Main Results:
- A significant negative correlation was found between the duration of CI use and P1 latency (r = -0.783, p < 0.001).
- In sequentially implanted children, longer duration with the first CI correlated with shorter P1 latency in the second CI ear (r = -0.710, p = 0.021).
- P1 latency with the first and second implants showed a significant positive correlation (r = 0.722, p = 0.018).
Conclusions:
- Extended cochlear implant use is associated with enhanced central auditory pathway maturation, evidenced by reduced P1 latency.
- Unilateral auditory experience from the first CI may positively influence the maturation of the central auditory pathway in the second CI ear.
- The degree of central auditory pathway maturation prior to the second CI, rather than the timing of surgery, may be a key factor in outcomes for children with sequential bilateral cochlear implants.
Objective:
To examine maturation of the central auditory pathway, using P1 cortical auditory evoked potential (CAEP), in children who had received unilateral or bilateral cochlear implantation (CI).
Study Design:
Prospective study.
Setting:
Tertiary referral hospital.
Methods:
Twenty children who had received CI due to congenital, or prelingual, deafness participated in the study. Participants had received the 1st implant at a mean age of 3.4 ± 0.7 years; 16 had also received a 2nd CI for the contralateral ear, at a mean age of 11.1 ± 2.1 years. P1 CAEP was recorded while using the 1st implant and, for those who received contralateral CI, within 2 weeks of switching on the 2nd implant. Relations between P1 latency and duration with the 1st implant, and between age at 1st CI and P1 latency, were investigated. Relations between P1 latency with the 1st and 2nd implants, and between the interstage interval and difference between P1 latencies with the 1st and 2nd implants, were also examined.
Results:
P1 CAEP with the 1st implant was present in 16 of the 20 children. Mean P1 latency was shorter in the early CI group compared with the late CI group, but this difference was not statistically significant (p = 0.154). There was a significant negative correlation between the duration with the 1st implant and P1 latency (r = - 0.783, p < 0.001). Among the 16 children with sequential bilateral CI, P1 CAEP with the 2nd implant was present in 10. There was a significant negative correlation between the duration with the 1st implant before receiving the 2nd implant and P1 latency with the 2nd implant (r = - 0.710, p = 0.021); there was also a significant positive correlation between P1 latency with the 1st and 2nd implants (r = 0.722, p = 0.018). There was not a significant correlation between interstage interval and the difference between the two P1 latencies (r = - 0.430, p = 0.248).
Conclusion:
Longer cochlear implant use is associated with shorter P1 latency. Unilateral hearing with the 1st implant may positively affect P1 latency with the 2nd CI ear. These findings imply that increased auditory experience may influence central auditory pathway maturation and that the degree of central auditory pathway maturation before the 2nd CI, rather than the timing when the surgery is received, may influence 2nd CI outcome in children with sequential bilateral cochlear implants.
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