Measurement of comfort levels by means of electrical stapedial reflex in children.
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.


OBJECTIVE
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.


METHODS
Before-after trial in the cochlear implant unit of a tertiary hospital.


METHODS
Programming with the ESR technique was successfully completed in 20 of a consecutive sample of 26 children undergoing programming of their cochlear implants.


METHODS
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.


CONCLUSIONS
Comfort level estimation by means of ESRs is reliable and objective and hence a valuable programming tool in the pediatric population.
Bresnihan
M
M
Cochlear Implant Unit, Beaumont Hospital, Dublin, Ireland. mary_bresnihan@hotmail.com
Norman
G
G
Scott
F
F
Viani
L
L
D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D019929:Cochlear Implantation; D004558:Electric Stimulation; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D012022:Reflex, Acoustic