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The Interphase Gap Effect in Cochlear Implant Users: Biological Basis, Parameter Selection, Analytical Methods, and

Shuman He1, Zi Gao2, Jacob J Oleson3

  • 1Eye and Ear Institute, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Suite 4000, Columbus, OH, 43212, USA. Shuman.He@osumc.edu.

Journal of the Association for Research in Otolaryngology : JARO
|March 17, 2026
PubMed
Summary

The interphase gap effect in cochlear implant users reflects the number of active cochlear nerve fibers, not their health. Stimulation level offset and maximum slope effectively indicate fiber counts.

Keywords:
Analysis methodCochlear nerve healthCochlear nerve survivalInterphase gap effectPhase locking valueQuantitative scale

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Area of Science:

  • Audiology and Bioengineering
  • Neuroscience
  • Medical Devices

Background:

  • The interphase gap (IPG) effect is a phenomenon observed in cochlear implant (CI) users.
  • Understanding the biological basis of the IPG effect is crucial for optimizing CI performance.
  • Previous research has explored various factors influencing CI outcomes, but the specific determinants of the IPG effect require further elucidation.

Purpose of the Study:

  • To determine the biological basis of the interphase gap (IPG) effect in cochlear implant (CI) users.
  • To identify the most informative parameters, analytical methods, and quantitative scales for evaluating the IPG effect.
  • To differentiate the contribution of cochlear nerve (CN) fiber number versus neural health to the IPG effect.

Main Methods:

  • Quantified the IPG effect using multiple parameters, analytical methods, and quantitative scales.
  • Compared three pediatric CI groups: cochlear nerve deficiency (CND), GJB2 mutations, and idiopathic sensorineural hearing loss (SNHL).
  • Assessed neural synchrony using phase locking value (PLV) to evaluate neural health.

Main Results:

  • Phase locking value (PLV) did not differ significantly between CND and GJB2 groups and did not correlate with the IPG effect.
  • Consistent group differences in IPG effects on stimulation level offset and maximum slope were observed across all methods.
  • Sensitivity of other electrophysiological measures (e.g., threshold, amplitude) varied by quantitative scale.

Conclusions:

  • The IPG effect is primarily determined by the number of active cochlear nerve (CN) fibers, not their health.
  • Stimulation level offset and the IPG effect on maximum slope are robust indicators of CN fiber counts.
  • These key indicators are independent of the chosen quantitative scale, offering reliable assessment in CI users.