Abstract
IntroductionIn cochlear implantation, objective fitting methods are needed to optimize audiological results in small children or patients with poor compliance. Intraoperatively measured electrically evoked stapedius reflexes (eSR) can be used as a marker for the patient’s discomfort level. The aim of this study was to develop and evaluate an automated detection method for eSR and to compare it to the detection rate of the surgeon and independent observers.MethodsCochlear implantation using a fully digital surgical microscope was performed. Movements of the stapedius tendon were recorded and analyzed by means of computer vision technique. Differences in eSR elicited by stimulating electrodes at different cochlear locations (basal, middle and apical) were analyzed. The eSR detection rate of the image processing algorithm was compared to the surgeon’s detection rate and to those of two less experienced observers.ResultsA total of 387 electrically impulses were applied. The stimulation of middle turn electrodes showed significantly higher detection rates (50.4%) compared to the basal (40.0%; p = 0.001) and apical (43.6%; p = 0.03) turn. The software identified significantly more of the applied stimuli (58.4%) compared to the surgeon (46.3%; p = 0.0007), the intermediate observer (37.7%; p < 0.0001) and the unexperienced observer (41.3%; p < 0.0001).ConclusionThe feasibility of an automated intraoperative software-based detection of eSR is demonstrated. By improving the eSR detection methods and their clinical applicability, their utility in objective cochlear implant fitting may be substantially increased.
Highlights
In cochlear implantation, objective fitting methods are needed to optimize audiological results in small children or patients with poor compliance
Correlations between the stimulus intensity and the length of the motion vector measured in pixels on the stapedius tendon were found for the basal, the middle and the apical electrodes of patient 1
Since the results of this study showed a clear trend to higher detection rates of the middle turn electrodes, stimulating the middle cochlear turn for elicited stapedius reflex threshold (eSRT) measurements is recommended
Summary
Objective fitting methods are needed to optimize audiological results in small children or patients with poor compliance. The stimulation of middle turn electrodes showed significantly higher detection rates (50.4%) compared to the basal (40.0%; p = 0.001) and apical (43.6%; p = 0.03) turn. By improving the eSR detection methods and their clinical applicability, their utility in objective cochlear implant fitting may be substantially increased. In the field of cochlear implantation, efficient objective fitting methods are becoming increasingly important to optimize audiological results in small children or patients with poor compliance. The technical limitation is due to background noise and low response amplitudes This method as introduced by Pau et al [4] is fairly invasive since a hook electrode needs to be inserted into the stapedius muscle. This method may disproportionally extend surgical time and causes additional surgical trauma
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
