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Correlation between neural response telemetry measurements and fitting levels.

Mihael Ries1, Iva Kelava2, Jakov Ajduk1

  • 1Department of Otorhinolaryngology, Sisters of Charity University Hospital Center, Vinogradska Cesta 29, Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 3a, Zagreb, Croatia.

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Summary

Evoked Action Potential (ECAP) thresholds measured 12 months post-implantation correlate best with cochlear implant fitting levels. Electrode 11 in the mid-cochlear region showed the strongest prediction for both threshold and comfort levels.

Keywords:
Amplitude growth functionCochlear implantsEvoked action potentialImpedanceNeural response telemetry

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Area of Science:

  • Audiology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Neural Response Telemetry (NRT) assesses cochlear implant function and auditory nerve response.
  • Previous studies show inconsistent correlations between NRT and subjective fitting levels (T and C).
  • Identifying the most predictive NRT measure for fitting levels remains unclear.

Purpose of the Study:

  • To determine which NRT measurement best predicts cochlear implant fitting levels.
  • To compare Impedance (IMP), Evoked Action Potential (ECAP) threshold, and Amplitude Growth Function (AGF) slope.
  • To identify the cochlear region with the strongest NRT-to-fitting level correlation.

Main Methods:

  • Retrospective study of 31 children with Cochlear implants.
  • NRT measures (IMP, ECAP threshold, AGF) recorded intra-operatively and at 12 months post-surgery.
  • Subjective T and C levels assessed at 12 months post-surgery.

Main Results:

  • ECAP thresholds at 12 months significantly correlated with T and C levels across all tested electrodes (5, 11, 19).
  • IMP correlated with C levels, and AGF showed a trend correlating with T levels, but not always significantly.
  • NRT measurements at 12 months post-surgery were more predictive than intra-operative ones.

Conclusions:

  • ECAP thresholds are superior to AGF slope and IMP in predicting T and C values.
  • Late post-operative NRT measurements (12 months) offer better prediction of fitting levels.
  • Electrode 11 (mid-cochlear region) demonstrated the highest correlation, suggesting this area is key for predicting fitting levels.