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Updated: Oct 10, 2026

Performing Repeated Intraoperative Impedance Telemetry Measurements during Cochlear Implantation
Published on: August 4, 2023
A device-independent approach to cochlear-implant telehealth
Joshua G W Bernstein1,2, Elicia M Pillion1,2, Sandeep A Phatak1
1National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Objective:
Commercial cochlear-implant (CI) telehealth is manufacturer-specific and generally does not replicate standard sound-field tests. This study developed and tested a manufacturer-independent CI telehealth system designed to replace a standard clinic visit.
Design:
The system comprised a laptop, a sound card, headphones (placed over the CI sound processor), manufacturer's programming software and cables, and custom software for aided speech-recognition and warble-tone detection-threshold assessment. Phase 1 compared telehealth-system aided assessment to standard sound-field testing. In Phase 2, participants completed at-home remote audiological follow-up visits.
Study Sample:
N = 15 (Phase 1) and N = 13 (Phase 2) adult CI users.
Results:
Mean absolute differences between telehealth-system and sound-field warble-tone detection thresholds were 5 dB, with 96% of 0.5-4 kHz telehealth-system thresholds within the sound-field 95% confidence interval (95ci). Consonant-nucleus-consonant word and AzBio sentence identification in quiet showed no significant differences between modes, with high intraclass correlations (ICC = 0.94-0.97) and 80-93% of telehealth-system scores within the sound-field 95ci. Bamford-Kowal-Bench sentence-in-noise scores showed larger deviations. Telehealth-survey responses indicated high patient satisfaction, improved convenience and access to care, and only minor challenges.
Conclusions:
Combining a manufacturer-independent headphones-based alternative to sound-field testing with manufacturer's programming software in a remotely controlled laptop system replicates sound-field outcome scores and produces high patient satisfaction.