Cochlear implants (CI) have been shown to be one of the most important components in bridging the gap between hearing loss in children. Recently, electrical stapedius reflex threshold (ESRT) based mapping has been used in children with CI. This systematic review aimed to identify the dominance of ESRT in attaining good upper stimulation levels in children, in comparison to other measures. Using a three-stage process, two authors screened the search results (7,739 records) from various electronic databases. Afterwards, the studies were further methodologically scrutinized, and relevant data were extracted. 12 full-text articles were included in this systematic review. Significant differences were seen in intraoperative and postoperative ESRT (p < 0.05). The positive correlation coefficient for ESRT-based (r=0.75) fitting was higher than that for electrical compound action potential (ECAP)-based fitting (r=0.39). Combined objective and subjective measurement yielded a positive correlation (r=0.90) and better outcomes (p < 0.05). ESRT is a key measure for attaining upper stimulation levels in different age groups of children. Although it does not replace other objective measures, ESRT may be more efficient than ECAP for the estimation of comfort levels. The combined use of both objective and behavioural measures is essential for the overall success of CI mapping.
Key words: electrical stapedius reflex threshold, cochlear implants, mapping, comfort levels, children, hearing loss
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