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Cochlear implants (CIs) often are the only option for people with severe to profound sensorineural hearing loss to be able to hear. Therefore, effective CI programming seems very important, especially in children who are still developing their speech. Using acoustic and electric stimulation (EAS) when possible may be even more beneficial. This study investigates whether using electrocochleography (ECochG), as opposed to behavioural audiometry, can be suitable to fit the acoustic component of CI. The authors compared two methods of acoustic component fitting in 10 implanted ears in total (eight children aged 3.5 to 15.5). Speech recognition and subjective feedback were compared for both types of fittings. Additionally, acoustic cut-off frequency was compared for both methods. The overall correlation between behavioural and ECochG thresholds was significant but lower than other studies have found. However, the specific frequency correlations were much lower for most of the measured frequencies. Interestingly, the cut-off frequencies determined using behavioural audiometry were significantly higher than using ECochG based audiometry. However, after excluding two participants’ data (three ears) the differences between both methods became statistically insignificant. The authors explained that the specific U-shaped audiogram for both participants had an impact on the cut-off frequency determination. Most of the participants preferred the EAS fitting based on ECochG. Although, there were no significant differences between speech recognition for both methods the overall trend indicated better scores for ECochG. Overall, the CI acoustic component fitting based on ECochG seems very promising. The time efficiency is much better as it reduces the thresholds measurements time from around 20 minutes to about one minute. However, it is important to stress that the sample size was not large and that more research is needed in the area.

Acoustic component programming in children with cochlear implants using electrocochleography.
Agrawal S, Coulthurst S, Nachman A, et al.
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Joanna Lemanska

De Montfort University, Leicester, UK.

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