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Updated: Aug 9, 2025
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Electrically evoked stapedial reflex threshold and behavioral method usefulness in the cochlear implant programming
Miguel Ángel Pérez-Rodríguez1, Salvador Francisco Torres-Gómez2, María Elena Conde-Pacheco2
1Servicio de Atención Médica, Hospital para el Niño Poblano, Puebla, MX, Mexico; Servicio de Audiología, Otoneurología y Foniatría, Hospital Regional ISSSTE, Puebla, Mx, Mexico.
Objetive:
To determine the utility of the electrically evoked stapedial reflex test (ESRT) and behavioral method in the CIs programming as an objective method to identify MCL levels in the CIs programming in pediatric patients.
Method:
Cross-sectional cohort study that included 20 pediatric patients with postlingual deafness and CI unilateral. They were performed clinical history, tympanometry, ESRT and by free field audiometry, before and after programming modifications according to MCL levels obtained by ESRT were performed. ESRT threshold was assessed with individual 300 ms stimuli on the 12 electrodes and recorded through manual decay. Likewise, the maximum comfort threshold (MCL) of each electrode was obtained through a behavioral analysis.
Results:
No significant differences were found between the ESRT and behavioral method in MCLs levels in each of the electrodes evaluated. In addition, the correlation coefficients were significant and located in a range of 0.55-0.81, higher in electrodes 7, 8, and 9 (r = 0.77, 0.76, and 0.81, respectively). However, the median hearing threshold established by the ESRT was significantly lower compared to the behavioral threshold (36.0 vs. 47.0 dB, p < 0.0001), regardless of age (p = 0.249) or the etiology of hearing loss (p = 0.292). The difference between the tests was in the number of times to do it, the ESRT was done once and the behavioral on average 4 ± 1 times.
Conclusion:
Similar MCL thresholds were obtained in both ESRT and behavioral test, establishing that both methods are reliable for use in pediatric patients; however, ESRT allows shortening the time to achieve normal hearing and language acquisition thresholds in a more optimal time.
