Cochlear implant (CI) programming requires subjective responses to a series of sophisticated psychophysical percepts. As many younger children now require implantation, it has become more important to develop objective methods for programming CI in young children who cannot provide a behavioral response. This is especially true when adjusting the sound levels to obtain the most comfortable loudness (MCL) level. Failure to indicate an elevation in loudness may result in an elevation of stimulus levels to the pain threshold. The electrically elicited stapedius muscle reflex threshold (ESRT) is an objective measurement that can be used for cochlear implant programming. OBJECTIVES: To evaluate the association between ESRT and psychophysical testsin order to estimate the MCL level. METHODS: ESRTs and psychophysical comfort levels were measured in 10 children with an MED-EL Sonata Implant with Opus 2 processing, that us for more than one year.The implant in every patient was activated and programmed based on their behavior. RESULTS: The data from the children was graphically represented, and the r value was found to be 1.03. Notably, all the data points were above the dotted line (r = 1.0), indicating that the ESRT was elicited by a level higher that the M levels used in their behavioral analysis. The M levels set are more conservative based on the ESRT levels. CONCLUSION: These results suggest that ESRTs may be an excellent objective measure for predicting MCL. A strong correlation was observed between the levels that elicit a threshold reflex response and the M levels obtained by behavioral analysis.
