Effect of stimulus duration on stapedius reflex threshold in electrical stimulation via cochlear implant.

The effect of stimulus duration on the threshold of the contralateral stapedius reflex was investigated in patients supplied with a Vienna cochlear implant (analog stimulation via CI) and compared to results of a normal-hearing reference group in case of acoustic stimulation. Changes in reflex threshold were determined at four frequencies (125, 500, 1,000 and 2,000 Hz in case of electrostimulation and at 500, 1,000, 2,000 and 4,000 Hz for acoustic stimulation) and for five durations (30, 50, 100, 300 and 500 ms). The comparison of the two stimulation modes was accomplished by using the same instrumentation and procedure. Reflex threshold was evaluated according to an objective criterion based on the individual noise distribution of recordings without reflex and by subjective judgement. For both stimulation modes a strong effect of stimulus duration on reflex threshold was observed (p < 0.001). The amount of temporal integration reflected by the threshold difference between 500 and 50 ms was approximately 2-4 dB for electrical stimulation via CI and 6 dB for acoustic stimulation in normal-hearing individuals. In case of electrostimulation, the reflex threshold for stimuli of 30 ms was most often above the limit of uncomfortable loudness sensation; the increase in reflex threshold for acoustic stimulation between 500 and 30 ms was approximately 14 dB. There was no evidence of frequency effect on reflex threshold nor an interaction between frequency and stimulus duration for either stimulation mode.