Electrical Stapedial Reflex Thresholds with MED-EL Cochlear Implants and Titan Middle Ear Analyser: A Practical Overview

Background

Research has shown a strong correlation between Electrical Stapedial Reflex Thresholds (eSRTs) and behaviourally measured Most Comfortable Levels (MCLs) with an 83% reported incidence (Kosaner et al. 2009). Nevertheless, eSRTs are still underutilised clinically. It is postulated that the main reason for eSRTs not being used more widely is the lack of integration between cochlear implant and immitance software.

Objective

The aim of this poster is to provide a practical overview of how MED-EL’s Maestro programming software and Interacoustics’ Titan Suite immitance software can run in parallel to measure eSRTs. A protocol designed in conjunction with Interacoutics is described.

Methods

72 newly implanted patients were tested between April 2016 and March 2017 using the described protocol. The protocol offers a continuous running time window, markers for electrode responses, a selection of different probe tones frequencies and a choice of different burst durations. Average time to measure responses across all 12 electrodes was reduced compared to behavioural mapping.

Results

Clear and definite eSRTs where measured in 46 patients. 26 patients did not have recordable eSRTs for reasons that will be discussed. This resulted in an incidence of 64%.

Conclusions

This protocol has proven successful in 2 out of 3 patients tested. The objective test is quick and easy to use and leads to a high degree of confidence in using this objective method to establish a map profile. In the future this may be improved further by implant and hearing instrumentation manufacturers collaborating to develop combined integrated systems.