Centro de Neurociencias de Cuba, Havanna, Cuba.
Programa Cubano de Implantes Cocleares, Havanna, Cuba.
Audiol Neurootol. 2021;26(3):164-172. doi: 10.1159/000510467. Epub 2021 Jan 12.
When mapping cochlear implant (CI) patients with limited reporting abilities, the lowest electrical stimulus level that produces a stapedial reflex (i.e., the electrical stapedius reflex threshold [eSRT]) can be measured to estimate the upper bound of stimulation on individual or a subset of CI electrodes. However, eSRTs measured for individual electrodes or a subset of electrodes cannot be used to predict the global adjustment of electrical stimulation levels needed to achieve comfortable loudness sensations that can be readily used in a speech coding strategy. In the present study, eSRTs were measured for 1-, 4-, and 15-electrode stimulation to (1) determine changes in eSRT levels as a function of the electrode stimulation mode and (2) determine which stimulation mode eSRT levels best approximate comfortable loudness levels from patients' clinical maps.
eSRTs were measured with the 3 different electrical stimulation configurations in 9 CI patients and compared with behaviorally measured, comfortable loudness levels or M-levels from patients' clinical maps.
A linear, mixed-effects, repeated-measures analysis revealed significant differences (p < 0.01) between eSRTs measured as a function of the stimulation mode. No significant differences (p = 0.059) were measured between 15-electrode eSRTs and M-levels from patients' clinical maps. The eSRTs measured for 1- and 4-electrode stimulation differed significantly (p < 0.05) from the M-levels on the corresponding electrodes from the patients' clinical map.
eSRT profiles based on 1- or 4-electrode stimulation can be used to determine comfortable loudness level on either individual or a subset of electrodes, and 15-electrode eSRT profiles can be used to determine the upper bound of electrical stimulation that can be used in a speech coding strategy.
在对报告能力有限的人工耳蜗植入(CI)患者进行映射时,可以测量产生镫骨肌反射的最低电刺激水平(即电镫骨肌反射阈值[eSRT]),以估计个体或 CI 电极子集的刺激上限。然而,不能使用针对单个电极或电极子集测量的 eSRT 来预测实现舒适响度感觉所需的电刺激水平的全局调整,这些感觉可以在言语编码策略中轻松使用。在本研究中,测量了 1、4 和 15 电极刺激的 eSRT,以(1)确定 eSRT 水平随电极刺激模式的变化,以及(2)确定哪种刺激模式 eSRT 水平最接近患者临床图中的舒适响度水平。
在 9 名 CI 患者中使用 3 种不同的电刺激配置测量 eSRT,并与患者临床图中的行为测量的舒适响度水平或 M 级进行比较。
线性混合效应重复测量分析显示,eSRT 随刺激模式的变化存在显著差异(p < 0.01)。15 电极 eSRT 与患者临床图中的 M 级之间无显著差异(p = 0.059)。1 电极和 4 电极刺激的 eSRT 与患者临床图中相应电极的 M 级显著不同(p < 0.05)。
基于 1 电极或 4 电极刺激的 eSRT 谱可用于确定个体或电极子集的舒适响度水平,而 15 电极 eSRT 谱可用于确定可用于言语编码策略的电刺激上限。