Abstract
Introduction
Cochlear nerve deficiency (CND) is characterized by a thin or absent cochlear branch
of the vestibulocochlear nerve, leading to sensorineural hearing loss (SNHL). The
effectiveness of cochlear implants (CIs) in patients with CND is debated, with some
studies indicating poor outcomes and others showing limited speech detection and discrimination
abilities. Accurate objective measures are essential for a successful CI mapping.
Objective
To investigate the use of global stimulation with live speech to measure electrically
evoked stapedial reflex thresholds (eSRTs) in CI recipients with CND and compare the
results with behavioral comfort levels.
Methods
This retrospective study reviewed the CI database from January 2015 to December 2023
to identify patients with CND. The eSRT measurements following CI were conducted using
a standard procedure. These levels were compared with the behavioral comfort levels
from their mapping data.
Results
From the CI database of 273 recipients, six children with CND were identified whose
eSRT levels were documented. Among these six, two children exhibited presence of electrical
stapedial reflexes that correlated well with behavioral comfort levels in response
to global stimulation of electrodes. None of them presented reflexes to individual
electrode stimulation.
Conclusion
Global stimulation of electrodes has the potential to elicit eSRT in patients with
CND more than individual electrode stimulation. Further research is crucial to validate
the effectiveness of global stimulation in eliciting eSRT in a larger cohort of patients
with CND. This would be a feasible test as an outcome measure, and it would help provide
better prognostic counselling.
Keywords
cochlear nerve deficiency - electrical stapedial reflex - post operative - children
- cochlear implant
Bibliographical Record
Megha Sasidharan, Anil Kumar, Pratik Agarwalla. Electrical Stapedial Reflex Thresholds
in Cochlear Implant Recipients with Cochlear Nerve Deficiency: A Retrospective Study.
Int Arch Otorhinolaryngol 2025; 29: s00451808276.
DOI: 10.1055/s-0045-1808276
