LL105 - Optimization in Cochlear Implant Programming Using Electrically Evoked Stapedial Reflex Threshold Measurements

Abstract:
There are multiple programming methods in cochlear implants, without consensus on the standard of care. Deaf patients with longstanding hearing deprivation, pediatrics, and the elderly may have difficulty judging loudness and pitch due to a lack of auditory memory or sound reference. Therefore, setting upper stimulation levels based on their judgments may be ineffective. This may lead to under or over-stimulation that can also affect patient satisfaction, quality of sound, and speech outcomes. Recent research and clinical experience at high-volume cochlear implant clinics, including the University of Miami, have found that patients programmed based on eSRTs are more comfortable in terms of loudness and yield improved speech discrimination scores when used appropriately. In addition, it is important to properly set lower stimulation levels, as access to low-level speech cues must also be considered. The measurement of threshold levels allows providers to enhance the capacity of CI recipients' comprehension of soft speech, especially in challenging listening scenarios encountered in daily life but also reduces cognitive effort in the recipients' listening activities throughout the day.