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Updated: Aug 18, 2026
Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
Published on: June 21, 2024
Stapedius reflex measurements in open sound-field in children using MED-EL cochlear implant systems
Rajdeep Kar1, Palani Saravanan2
1Department of ENT, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Insights
Stapedius reflex thresholds (sf-SRT) in pediatric cochlear implant (CI) users were reliable and comparable to normal hearing children. These findings support using sf-SRT to determine upper stimulation levels in pediatric CI users.
Area of Science:
- Audiology
- Hearing Science
- Biomedical Engineering
Background:
- Cochlear implants (CI) are vital for hearing restoration in children.
- Assessing auditory function in pediatric CI users is crucial for optimizing device settings.
- Stapedius reflex thresholds (SRT) provide insights into auditory pathway function.
Purpose of the Study:
- To compare sound field stapedius reflex thresholds (sf-SRT) in pediatric CI users and normal-hearing children.
- To evaluate the reliability of sf-SRT measurements in pediatric CI users.
- To determine the utility of sf-SRT for setting upper stimulation levels in pediatric CI devices.
Main Methods:
- The study involved 19 pediatric CI users (MED-EL system) and 20 normal-hearing children (ages 3-12).
- Sound field stapedius reflex thresholds (sf-SRT) were measured using narrow-band noise (NBN) at 0.5, 1, 2, 4 kHz and broad-band noise (BBN).
- Measurements were repeated in two separate sessions to assess test-retest reliability.
Main Results:
- sf-SRT levels varied from 65-103 dB HL in CI users and 70-90 dB HL in normal-hearing children.
- CI users showed significantly higher sf-SRT levels for 2 kHz NBN compared to normal-hearing children.
- In CI users, sf-SRT levels for 2 kHz NBN were significantly higher than for 0.5 kHz NBN and BBN.
- sf-SRT measurements demonstrated high reliability in the CI group.
Conclusions:
- Sound field stapedius reflex thresholds (sf-SRT) are reliable in pediatric cochlear implant (CI) users.
- sf-SRT measurements can be effectively used to determine appropriate upper stimulation levels for pediatric CI users.
- These findings contribute to optimizing audiological management in children with CIs.
Objectives:
The study compared stapedius reflex thresholds during presentation of acoustic stimuli in an open sound field (sf-SRT) in paediatric cochlear implant (CI) users with the MED-EL system and children with bilateral normal hearing sensitivity.
Design:
The sf-SRT was measured using open-sound-field acoustic stimulation with narrow-band noise (NBN) centred at 0.5, 1, 2, and 4 kHz, and broad-band noise (BBN). The sf-SRTs were measured twice in two different sessions.
Study Sample:
Nineteen unilateral paediatric CI users and twenty children with bilateral normal hearing sensitivity, with an age range from 3 to 12 years.
Results:
The sf-SRT levels ranged from 65 to 103 dB HL and 70 to 90 dB HL across stimulus types in the CI and normal-hearing groups, respectively. Mann-Whitney U test revealed that the CI group had significantly higher sf-SRT levels for 2 kHz NBN than the normal-hearing group. In the CI group, repeated-measures ANOVA revealed significantly higher sf-SRT levels for NBN centred at 2 kHz than for 0.5 kHz and BBN. The sf-SRT measurements were reported to be reliable in the CI group.
Conclusion:
High test-retest reliability was demonstrated, supporting the use of sf-SRT measurements to confirm upper stimulation levels in paediatric CI users.