Correlation of Electrophysiological and Behavioral Response in Cochlear Implant Candidates

Article Information

Title: Correlation of Electrophysiological and Behavioral Response in Cochlear Implant Candidates

Authors: Syed Bilal Hussain Shah, Zaimal Shahan, Maryiam Asghar, Mohammad Zubair Khan, Mohsin Raza, Wajih-ud-din Shinwari

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2024

Volume: 74

Issue: 4

Language: English

Keywords: Auditory Steady State ResponseCochlear ImplantHearing LossPatient Outcome Assessment.

Abstract

Objective: To determine the effect of Cochlear Implants on electrophysiological and behavioural response in children with hearing impairment at frequencies of 500, 1000, 2000, and 4000 Hz.
Study Design: Cross sectional study.
Place and Duration of Study: Department of ENT, Combined Military Hospital Rawalpindi Pakistan, from Jul 2021 to Jul 2022.
Methodology: Seventy children with hearing impairment aged 2-12 years of either gender, who had undergone cochlear implantation were part of the study. Language and hearing conditions were examined during the audiological assessment of candidates for cochlear implantation. At ER-tone 5A and TDH-39 using ISO 389-2 and 389-1 calibrations, warble tones given at different frequencies were used to derive behavioral air conduction thresholds. The Auditory Steady State Response test began with a carrier frequency of 500 Hz and advanced to frequencies of 1000, 2000, and 4000 Hz. Thresholds were set using a 10 dB down and 5 dB up procedure until no responses could be captured. Behavioral and Auditory Steady State Response responses were noted in all patients.
Results: Mean age of the patients was 6.66±2.74 years. Behavioral threshold&gt;110 dB HL were obtained in 8(11.4%) subjects, 10(14.3%) had behavioral thresholds from 100 to 110 dB HL, and 52(74.3%) had &lt;100 dB HL. Eleven patients obtained Auditory Steady State Response thresholds&gt;110 dB HL (15.7%), 31(44%) achieved 100 to 110 dB HL and 28(40%) achieved &lt;100 dB HL. The most common frequency was 500 Hz. Statistically insignificant difference was found between .......
Conclusion: Cochlear implantation has positive effect on behavioral and ...

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Research Objective

To determine the effect of Cochlear Implants on electrophysiological and behavioural response in children with hearing impairment at frequencies of 500, 1000, 2000, and 4000 Hz.

Methodology

Cross-sectional study conducted at the ENT Department of Combined Military Hospital Rawalpindi Pakistan, from July 2021 to July 2022. Seventy children aged 2-12 years with hearing impairment who had undergone cochlear implantation were included. Behavioral air conduction thresholds were derived using warble tones at different frequencies. Auditory Steady State Response (ASSR) test was performed with carrier frequencies of 500, 1000, 2000, and 4000 Hz. Data was analyzed using SPSS version 23.0, with Chi-square/Fisher exact test for comparisons.

Methodology Flowchart

                        graph TD
    A["Study Approval & Ethics"] --> B["Participant Recruitment"];
    B --> C["Informed Consent"];
    C --> D["Baseline Data Collection: Age, Gender, CI Type"];
    D --> E["Audiological Assessment"];
    E --> F["Behavioral Air Conduction Thresholds"];
    E --> G["Auditory Steady State Response"ASSR" Test"];
    F --> H["Data Analysis"];
    G --> H;
    H --> I["Statistical Comparison"];
    I --> J["Results Interpretation"];
    J --> K["Conclusion"];

Discussion

Cochlear implantation is a tested method for severe to profound hearing impairment. For young children and those with syndromic associations, establishing behavioral thresholds can be difficult, making objective electrophysiological measurements like ASSR useful for programming. The study found a strong correlation between ASSR and behavioral tests in patients with hearing loss, with a narrower gap between them indicating a higher degree of hearing loss.

Key Findings

Mean age of patients was 6.66±2.74 years. Behavioral thresholds were <100 dB HL in 74.3% of subjects, 100-110 dB HL in 14.3%, and >110 dB HL in 11.4%. ASSR thresholds were <100 dB HL in 40%, 100-110 dB HL in 44%, and >110 dB HL in 15.7%. The most common frequency for both was 500 Hz. A statistically insignificant difference was found between behavioral and ASSR thresholds (p=0.227).

Conclusion

Cochlear implantation has a positive effect on behavioral and electrophysiological responses in children with hearing impairment.

Fact Check

1. Study Duration: The study was conducted from July 2021 to July 2022. (Confirmed in Methodology)
2. Sample Size: Seventy children with hearing impairment were part of the study. (Confirmed in Methodology and Results)
3. Statistical Significance: A statistically insignificant difference was found between behavioral and Auditory Steady State Response thresholds (p=0.227). (Confirmed in Results)

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