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Measurement of Comfort Levels by Means of Electrical Stapedial Reflex in Children
Mary Bresnihan, AFRCSI;
Gary Norman, MSc;
Fiona Scott, MSc;
Laura Viani, FRCSI, BSc
Arch Otolaryngol Head Neck Surg. 2001;127:963-966.
Background Patient success and satisfaction with a cochlear implant largely depend
on the adequacy of the speech-processing program. The program is generated
by means of behaviorally determined threshold and comfort levels for each
electrode. As the minimum age for implantation continues to decrease, behavioral
methods of measuring comfort levels have become more problematic, and so the
need for objective ways to program speech processors has become more important.
Objectives To evaluate the use of electrically evoked stapedial reflexes (ESRs)
to measure comfort levels for children and compare these results with behavioral
measurements, and to report the results of a questionnaire assessing the acceptability
and general performance of program before and after adjustment of comfort
levels measured with ESRs.
Design and Setting Before-after trial in the cochlear implant unit of a tertiary hospital.
Patients and Methods Programming with the ESR technique was successfully completed in 20
of a consecutive sample of 26 children undergoing programming of their cochlear
implants.
Outcome Measures Programming units as measured by the 2 programming techniques and numerical
score of questionnaire.
Results Comfort levels with the ESR method were found to be consistently lower
than those obtained with behavioral techniques. Children using programs set
with ESRs wore their implants longer and had fewer episodes of discomfort
to environmental sounds.
Conclusion Comfort level estimation by means of ESRs is reliable and objective
and hence a valuable programming tool in the pediatric population.
From the Cochlear Implant Programme, Beaumont Hospital, Dublin, Ireland.
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Arch Otolaryngol Head Neck Surg. 2001;127(8):1011-1012.
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