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Updated: Feb 12, 2026

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Relation between open-field stapedius reflex thresholds and speech perception in CI users
Annett Franke-Trieger1, Willy Mattheus1, Josef Seebacher2
1Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital), Technische Universität Dresden, Dresden, Germany.
Objective:
To evaluate the relationship between open-field stapedius reflex thresholds (oSRT) and word recognition scores (WRS) in cochlear implant (CI) users and to assess the effectiveness of electrically evoked stapedius reflex threshold (eSRT)-based CI fitting compared with conventional subjective fitting.
Design:
In this prospective study, oSRTs and WRS were measured in 39 experienced MED-EL CI users (44 ears) fitted by subjective methods. The CI users were classified into three groups according to whether their oSRTs were above, within or below a reference range derived from normal-hearing listeners. A subset of 15 CI users also underwent an alternative fitting procedure based on eSRT, and WRS were re-evaluated.
Results:
Subjects with oSRTs within the reference range showed significantly better WRS (mean 53%) compared with those who had oSRTs above or below the range (mean 30%). eSRT-based fitting improved mean WRS in both groups.
Conclusions:
oSRTs outside the 'normal' range are associated with poorer speech perception, supporting their use as an objective marker for under- or overstimulation. Furthermore, eSRT-based fitting improves speech outcomes and may optimise stimulation even in seemingly well-fitted users. These findings emphasise the potential value of incorporating objective measures such as oSRT and eSRT into routine fitting procedures.
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