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S2 Intraoperative/objective measurements
Time evolution of comfort levels based on electrically evoked stapedius reflex thresholds in children
with CI
Seebacher J. , Koci V. , Stephan K.
Innsbruck Medical University, Dept. Hearing, Speech, and Voice Disorders, Innsbruck, Austria
Intro: In clinical application the electrically evoked stapedius reflex threshold (ESRT) serves as a robust
estimator of maximum comfortable loudness levels required for fitting of cochlear implants. Postoperative ESRTs
are typically obtained from acoustic impedance measurements using appropriate ear probes. These
measurements are possible whenever the middle ear function of the patient is normal, which is the case in about
90% of the patients. Up to now it is not known how much the ESRT values change over time with regular implant
use. This information is particularly important for the refitting of cochlear implants in children based on objective
Methods: In the present retrospective study the time evolution of ESRTs has been studied. 36000 ESRT
measurements, which have been collected over a period of 12 years for 40 children supplied with MED-EL
cochlear implants, have been analyzed at the common time intervals used for fitting. As reference the change of
maximum comfort loudness levels over time was evaluated in an independent sample of 10 adult CI patients
fitted with conventional behavioral methods.
Results: The postoperatively determined ESRTs show considerable changes within the first year of cochlear
implant use for all children tested. On average a change of maximum comfortable loudness levels based on
ESRT of 22% is observed. For the majority of implants an increasing trend of charge levels was observed.
Though a small fraction of implants showed decreasing ESRT levels and hence a common trend cannot be
stated. Maximum comfort loudness levels stabilized after about one year of implant use in all patients. The
change of maximum comfort loudness levels based on conventional loudness scaling was ranging within
comparable limits.