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Comparison of Pure-Tone Thresholds and Cochlear Microphonics Thresholds in Pediatric Cochlear Implant Patients. 2020

Sarah Coulthurst, and Alison J Nachman, and Mike T Murray, and Kanthaiah Koka, and Aniket A Saoji
Pediatric Audiology and Cochlear Implant Program, University of California at San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA.

In adult cochlear implant patients, conventional audiometry is used to measure postoperative residual hearing which requires active listening and patient feedback. However, audiological measurements in pediatric cochlear implant patients are both challenging as well as time consuming. Intracochlear electrocochleography (ECOG) offers an objective and a time-efficient method to measure frequency-specific cochlear microphonic or difference thresholds (CM/DIF) thresholds that closely approximate auditory thresholds in adult cochlear implant patients. The correlation between CM/DIF and behavioral thresholds has not been established in pediatric cochlear implant patients. In the present study, CM/DIF thresholds were compared with audiometric thresholds in pediatric cochlear implant patients with postoperative residual hearing. Thirteen (11 unilateral and 2 bilateral) pediatric cochlear implant patients (mean age = 9.2 years ± 5.1) participated in this study. Audiometric thresholds were estimated using conventional, condition play, or visual reinforcement audiometry. A warble tone stimulus was used to measure audiometric thresholds at 125, 250, 500, 1000, and 2000 Hz. ECOG waveforms were elicited using 50-msec acoustic tone-bursts. The most apical intracochlear electrode was used as the recording electrode with an extra-cochlear ground electrode. The ECOG waveforms were analyzed to determine CM/DIF thresholds that were compared with pediatric cochlear implant patients' audiometric thresholds. The results show a significant correlation (r = 0.77, p < 0.01) between audiometric and CM/DIF thresholds over a frequency range of 125 to 2000 Hz in pediatric cochlear implant patients. Frequency-specific comparisons revealed a correlation of 0.82, 0.74, 0.69, 0.41, and 0.32 between the audiometric thresholds and CM/DIF thresholds measured at 125, 250, 500, 1000, and 2000 Hz, respectively. An average difference of 0.4 dB (±14 dB) was measured between the audiometric and CM/DIF thresholds. Intracochlear ECOG can be used to measure CM/DIF thresholds in pediatric cochlear implant patients with residual hearing in the implanted ear. The CM/DIF thresholds are similar to the audiometric thresholds at lower test frequencies and offer an objective method to monitor residual hearing in difficult-to-test pediatric cochlear implant patients.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003054 Cochlear Implants Electronic hearing devices typically used for patients with normal outer and middle ear function, but defective inner ear function. In the COCHLEA, the hair cells (HAIR CELLS, VESTIBULAR) may be absent or damaged but there are residual nerve fibers. The device electrically stimulates the COCHLEAR NERVE to create sound sensation. Auditory Prosthesis,Cochlear Prosthesis,Implants, Cochlear,Auditory Prostheses,Cochlear Implant,Cochlear Prostheses,Implant, Cochlear,Prostheses, Auditory,Prostheses, Cochlear,Prosthesis, Auditory,Prosthesis, Cochlear
D006309 Hearing The ability or act of sensing and transducing ACOUSTIC STIMULATION to the CENTRAL NERVOUS SYSTEM. It is also called audition. Audition
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000161 Acoustic Stimulation Use of sound to elicit a response in the nervous system. Auditory Stimulation,Stimulation, Acoustic,Stimulation, Auditory
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D001300 Audiometry, Evoked Response A form of electrophysiologic audiometry in which an analog computer is included in the circuit to average out ongoing or spontaneous brain wave activity. A characteristic pattern of response to a sound stimulus may then become evident. Evoked response audiometry is known also as electric response audiometry. Audiometry, Electroencephalic Response,Electrocochleography,Evoked Response Audiometry,Audiometries, Electroencephalic Response,Audiometries, Evoked Response,Electrocochleographies,Electroencephalic Response Audiometries,Electroencephalic Response Audiometry,Evoked Response Audiometries,Response Audiometries, Electroencephalic,Response Audiometries, Evoked,Response Audiometry, Electroencephalic,Response Audiometry, Evoked
D001301 Audiometry, Pure-Tone Measurement of hearing based on the use of pure tones of various frequencies and intensities as auditory stimuli. Audiometry, Bekesy,Audiometry, Pure Tone,Bekesy Audiometry,Pure-Tone Audiometry
D001309 Auditory Threshold The audibility limit of discriminating sound intensity and pitch. Auditory Thresholds,Threshold, Auditory,Thresholds, Auditory

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