Prediction of Dynamic Range from Stapedius Reflex in Cochlear Implant Patients

1988 ◽  
Vol 9 (1) ◽  
pp. 4-8 ◽  
Author(s):  
James Jerger ◽  
Terrey A. Oliver ◽  
Rose A. Chmiel
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Stapedius Reflex

The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant

2018 ◽  
Vol 29 (04) ◽  
pp. 292-299 ◽  
Author(s):  
Kelly Cristina Lira de Andrade ◽  
Lilian Ferreira Muniz ◽  
Pedro de Lemos Menezes ◽  
Silvio da Silva Caldas Neto ◽  
Aline Tenório Lins Carnaúba ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Case Series ◽  
Comfort Level ◽  
Small Children ◽  
Case Series Study ◽  
Significant Difference ◽  
Stapedius Reflex ◽  
Reflex Threshold ◽  
Maximum Comfort

AbstractOne of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.Cross-sectional analytical observational case series study.We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer’s software (custom sound Ep 3–2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey’s honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov–Smirnov test examined whether significant relationships existed between these other factors.The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.

Dynamic Range of the Contralateral Stapedius Reflex in Cochlear Implant Patients

1990 ◽  
Vol 19 (2) ◽  
pp. 111-115 ◽  
Author(s):  
K. Stephan ◽  
K. Welzl-Müller ◽  
H. Stiglbrunner
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Stapedius Reflex

Effect of different input dynamic range variables on cochlear implant performance in postlingual cochlear implant in adults

2019 ◽  
Vol 69 (3) ◽  
Author(s):  
Tarek A. Ghannoum ◽  
Mona H. Selim ◽  
Amira M. El-Shennawy ◽  
Zahraa M. Elbohy
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range

Effect of Speech Processor Program Modifications on Cochlear Implant Recipients’ Threshold and Maximum Acceptable Loudness Levels

1999 ◽  
Vol 8 (2) ◽  
pp. 128-136 ◽  
Author(s):  
John C. Sun ◽  
Margarate W. Skinner ◽  
S. Y. Liu ◽  
T. S. Huang
Keyword(s):  
Electrical Stimulation ◽  
Cochlear Implant ◽  
Everyday Life ◽  
Dynamic Range ◽  
Active Electrode ◽  
Speech Processor ◽  
Significant Change ◽  
Upper Boundary

This study’s purpose was to determine whether or not modifications in speech processor electrical stimulation levels were associated with changes in five Nucleus 22 cochlear implant recipients’ thresholds or maximum acceptable loudness levels (MALs). These modifications in minimum and maximum stimulation levels were made to optimize hearing in everyday life. One threshold and one MAL were obtained on each active electrode during six, weekly test sessions, three before and three after program modification. Only one participant had a significant change in threshold after program modification; this participant and four others had significant changes in MAL. Participants’ threshold variability was the same, but MAL variability was higher than that observed in other studies. Because these participants had no experience making MAL judgments prior to this study, this result suggests that implant recipients should be given sufficient practice in making MAL judgments to provide a stable clinical estimate of the upper boundary of the electrical dynamic range.

scholarly journals Comparison of Electrically Evoked Compound Action Potential Thresholds and Loudness Estimates for the Stimuli Used to Program the Advanced Bionics Cochlear Implant

2010 ◽  
Vol 21 (01) ◽  
pp. 016-027 ◽  
Author(s):  
Eun Kyung Jeon ◽  
Carolyn J. Brown ◽  
Christine P. Etler ◽  
Sara O'Brien ◽  
Li-Kuei Chiou ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Dynamic Range ◽  
Compound Action Potential ◽  
Behavioral Measures ◽  
Speech Processor ◽  
Compound Action Potentials ◽  
Evoked Compound Action Potential ◽  
The Individual ◽  
The Relationship ◽  
Compound Action

Background: In the mid-1990s, Cochlear Corporation introduced a cochlear implant (CI) to the market that was equipped with hardware that made it possible to record electrically evoked compound action potentials (ECAPs) from CI users of all ages. Over the course of the next decade, many studies were published that compared ECAP thresholds with levels used to program the speech processor of the Nucleus CI. In 2001 Advanced Bionics Corporation introduced the Clarion CII cochlear implant (the Clarion CII internal device is also known as the CII Bionic Ear). This cochlear implant was also equipped with a system that allowed measurement of the ECAP. While a great deal is known about how ECAP thresholds compare with the levels used to program the speech processor of the Nucleus CI, relatively few studies have reported comparisons between ECAP thresholds and the levels used to program the speech processor of the Advanced Bionics CI. Purpose: To explore the relationship between ECAP thresholds and behavioral measures of perceptual dynamic range for the range of stimuli commonly used to program the speech processor of the Advanced Bionics CI. Research Design: This prospective and experimental study uses correlational and descriptive statistics to define the relationship between ECAP thresholds and perceptual dynamic range measures. Study Sample: Twelve postlingually deafened adults participated in this study. All were experienced users of the Advanced Bionics CI system. Data Collection and Analysis: ECAP thresholds were recorded using the commercially available SoundWave software. Perceptual measures of threshold (T-level), most comfortable level (M-level), and maximum comfortable level (C-level) were obtained using both “tone bursts” and “speech bursts.” The relationship between these perceptual and electrophysiological variables was defined using paired t-tests as well as correlation and linear regression. Results: ECAP thresholds were significantly correlated with the perceptual dynamic range measures studied; however, correlations were not strong. Analysis of the individual data revealed considerable discrepancy between the contour of ECAP threshold versus electrode function and the behavioral loudness estimates used for programming. Conclusion: ECAP thresholds recorded from Advanced Bionics cochlear implant users always indicated levels where the programming stimulus was audible for the listener. However, the correlation between ECAP thresholds and M-levels (the primary metric used to program the speech processor of the Advanced Bionics CI), while statistically significant, was quite modest. If programming levels are to be determined on the basis of ECAP thresholds, care should be taken to ensure that stimulation is not uncomfortably loud, particularly on the basal electrodes in the array.

Evaluation of Automatic Directional Processing with Cochlear Implant Recipients

2021 ◽  
Vol 32 (08) ◽  
pp. 478-486
Author(s):  
Lisa G. Potts ◽  
Soo Jang ◽  
Cory L. Hillis
Keyword(s):  
Signal Processing ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Mixed Model ◽  
Dynamic Range ◽  
Individual Variability ◽  
Noise Performance ◽  
Mixed Model Analysis ◽  
Speech In Noise ◽  
Speech Recognition In Noise

Abstract Background For cochlear implant (CI) recipients, speech recognition in noise is consistently poorer compared with recognition in quiet. Directional processing improves performance in noise and can be automatically activated based on acoustic scene analysis. The use of adaptive directionality with CI recipients is new and has not been investigated thoroughly, especially utilizing the recipients' preferred everyday signal processing, dynamic range, and/or noise reduction. Purpose This study utilized CI recipients' preferred everyday signal processing to evaluate four directional microphone options in a noisy environment to determine which option provides the best speech recognition in noise. A greater understanding of automatic directionality could ultimately improve CI recipients' speech-in-noise performance and better guide clinicians in programming. Study Sample Twenty-six unilateral and seven bilateral CI recipients with a mean age of 66 years and approximately 4 years of CI experience were included. Data Collection and Analysis Speech-in-noise performance was measured using eight loudspeakers in a 360-degree array with HINT sentences presented in restaurant noise. Four directional options were evaluated (automatic [SCAN], adaptive [Beam], fixed [Zoom], and Omni-directional) with participants' everyday use signal processing options active. A mixed-model analysis of variance (ANOVA) and pairwise comparisons were performed. Results Automatic directionality (SCAN) resulted in the best speech-in-noise performance, although not significantly better than Beam. Omni-directional performance was significantly poorer compared with the three other directional options. A varied number of participants performed their best with each of the four-directional options, with 16 performing best with automatic directionality. The majority of participants did not perform best with their everyday directional option. Conclusion The individual variability seen in this study suggests that CI recipients try with different directional options to find their ideal program. However, based on a CI recipient's motivation to try different programs, automatic directionality is an appropriate everyday processing option.

Experimental Basis and Design of a New Cochlear Prosthesis System

1987 ◽  
Vol 96 (1_suppl) ◽  
pp. 76-79
Author(s):  
J. Génin ◽  
R. Charachon
Keyword(s):  
Theoretical Model ◽  
Integrated Circuits ◽  
Cochlear Implant ◽  
Dynamic Range ◽  
Complementary Metal Oxide Semiconductor ◽  
Metal Oxide Semiconductor ◽  
Oxide Semiconductor ◽  
Semiconductor Technology ◽  
Experimental Basis ◽  
Cochlear Prosthesis

In a multichannel cochlear prosthesis, electrical interactions between electrodes impose severe limitations on dynamic range and selectivity. We present a theoretical model to cope with these limitations. Building a successful cochlear implant requires full custom-integrated circuits. We present the design of such a device, implemented in complementary metal oxide semiconductor technology. The area of the chip is 9 mm2 and it can stimulate 15 cochlear electrodes with current impulses.

Sign in / Sign up

Export Citation Format

Share Document