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Updated: Sep 13, 2025
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
A Study of Correlation Between Intra-operative Electrically Evoked Stapedial Reflex and Neural Response Telemetry
Priya Dogra1, Prem Singh Jat1, Sunita Agarwal1
1Department of Otorhinolaryngology and Head and Neck Surgery, S.M.S. Medical College, 402 - Luxurious Landings, 92/8, Mahaveer Nagar, Durgapura, Jaipur, Rajasthan India.
Insights
Objective measures like electrically evoked Stapedial Reflex (eSRT) and Neural Response Telemetry (NRT) can predict cochlear implant comfort levels in children. These intraoperative tests reliably estimate the Maximum Comfort Level (MCL), aiding programming for difficult-to-test pediatric patients.
Area of Science:
- Audiology
- Otolaryngology
- Biomedical Engineering
Background:
- Psychophysical measurements for T and C-levels are challenging in pediatric cochlear implant recipients.
- Objective electrophysiological measures offer a viable alternative for assessing auditory nerve function and stimulation levels.
Purpose of the Study:
- To correlate intraoperative electrically evoked Stapedial Reflex (eSRT) and Neural Response Telemetry (NRT) levels with the Maximum Comfort Level (MCL) in children.
- To evaluate the utility of eSRT and NRT in programming cochlear implants for pediatric patients.
Main Methods:
- Thirty children undergoing cochlear implantation were enrolled.
- Intraoperative eSRT and NRT were measured using single-electrode stimulation.
- Post-operative Maximum Comfort Level (MCL) was documented three weeks after implant activation.
Main Results:
- A statistically significant positive correlation was found between intraoperative eSRT and MCL (r²=0.755).
- A statistically significant positive correlation was observed between intraoperative NRT and MCL (r²=0.698).
Conclusions:
- Intraoperative eSRT and NRT testing can reliably predict behavioral MCL in children.
- These objective measures are valuable for programming cochlear implants, especially in pediatric patients who are difficult to test.
Abstract:
Psychophysical measurements of T and C-levels are difficult in children. Electrically evoked Stapedial Reflex (eSRT) and Neural Response Telemetry (NRT) is an objective method to measure the same. This study aims to correlate intraoperative eSRT and NRT levels with Maximum Comfort Level (MCL) in children and ascertain its usefulness in programming a cochlear implant. Thirty children undergoing cochlear implant surgery were included. Intra-operative eSRT and NRT was measured using single electrode stimulation on third electrode. After three weeks, implant was switched on and MCL were documented. We observed a statistically significant positive correlation of eSRT (r2-0.755) and NRT (r2-0.698) with maximum comfort level. Intra-operative eSRT and NRT testing can reliably predict the behavioural MCL, and can be useful for evaluating patients who are difficult to test.
