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Updated: Jun 12, 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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The effect of current amplitude and multi-electrode stimulation on eSRT for auditory fitting in cochlear implants
Behnam Molaee-Ardekani1,2, Pedro Goiana-Martins3,4, Manuel Segovia-Martinez2
1Cochlear Ltd, Advanced Innovation Department, Vallauris, France.
Cochlear Implants International
|February 1, 2025
Summary
Increasing stimulation amplitude and using multi-electrode stimulation in cochlear implants significantly improves electrically evoked Stapedius Reflex Threshold (eSRT) detection rates. This enhances the estimation of the Most Comfortable Loudness level (MCL) without compromising accuracy.
Area of Science:
- Neuroscience and Biomedical Engineering
- Auditory Electrophysiology
- Cochlear Implant Technology
Background:
- Personalized cochlear implant (CI) programming relies on neurophysiologic measures.
- The electrically evoked Stapedius Reflex Threshold (eSRT) is a key measure for assessing auditory nerve response.
- Understanding factors influencing eSRT is crucial for optimizing CI efficacy.
Purpose of the Study:
- To evaluate the impact of stimulation current amplitude and electrode count on eSRT.
- To assess the correlation between eSRT and the Most Comfortable Loudness level (MCL).
- To identify optimal stimulation parameters for reliable eSRT-based MCL estimation in pseudo-monophasic CI systems.
Main Methods:
- Seventeen adult patients with Oticon Medical CI devices participated.
- Stimulation involved varying current amplitudes (low/high) and electrode group sizes (1, 3, 5) across cochlear regions.
- eSRT detection rates and correlation with MCL were analyzed under different stimulation conditions.
Main Results:
- Multi-electrode stimulation (G3, G5) significantly improved eSRT detection compared to single electrodes (G1).
- Higher stimulation amplitudes generally increased eSRT detection rates.
- A strong correlation (r=0.64-0.87) was consistently observed between eSRT and MCL across conditions.
Conclusions:
- Increasing stimulation amplitude and utilizing multi-electrode configurations enhance eSRT detection in pulse-width modulated CIs.
- Optimal parameters for MCL estimation from eSRT were identified (e.g., high-amplitude contra-lateral G5).
- These findings support the use of eSRT for more accurate and personalized CI programming.
