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Updated: Dec 13, 2025
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Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
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Automated detection of electrically evoked stapedius reflexes (eSR) during cochlear implantation
Nora M Weiss1, Attila Óvári1,2, Tobias Oberhoffner1
1Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.
Summary
An automated software method effectively detects intraoperative electrically evoked stapedius reflexes (eSR) during cochlear implantation. This automated detection surpasses human observers, offering improved objective fitting for patients.
Area of Science:
- Otolaryngology
- Biomedical Engineering
- Audiology
Background:
- Objective fitting methods are crucial for cochlear implantation, especially in pediatric patients or those with poor compliance.
- Intraoperative electrically evoked stapedius reflexes (eSR) serve as an indicator of patient discomfort.
- Current eSR detection relies on subjective human observation, necessitating more objective approaches.
Purpose of the Study:
- To develop and validate an automated software-based method for detecting eSR during cochlear implantation.
- To compare the performance of the automated eSR detection system against human observers (surgeon and less experienced individuals).
Main Methods:
- Cochlear implantation was performed using a digital surgical microscope.
- Stapedius tendon movements were captured and analyzed using computer vision techniques.
- The automated algorithm's eSR detection rate was compared to that of the surgeon and two independent observers.
Main Results:
- The automated software detected significantly more stimuli (58.4%) compared to the surgeon (46.3%) and observers (37.7%-41.3%).
- Middle turn electrode stimulation yielded higher eSR detection rates (50.4%) than basal (40.0%) or apical (43.6%) electrodes.
- The study demonstrated the feasibility of automated intraoperative eSR detection.
Conclusions:
- An automated, software-based approach for intraoperative eSR detection in cochlear implantation is feasible.
- Enhanced eSR detection methods can improve objective cochlear implant fitting.
- This technology holds potential for optimizing audiological outcomes in cochlear implant recipients.
