Amplitude Growth Functions of Auditory Nerve Responses to Electric Pulse Stimulation With Varied Interphase Gaps in Cochlear Implant Users With Ipsilateral Residual Hearing
Marina Imsiecke, Andreas Büchner, Thomas Lenarz, Waldo Nogueira
Abstract
Amplitude growth functions (AGFs) of electrically evoked compound action potentials (eCAPs) with varying interphase gaps (IPGs) were measured in cochlear implant users with ipsilateral residual hearing (electric-acoustic stimulation [EAS]). It was hypothesized that IPG effects on AGFs provide an objective measure to estimate neural health. This hypothesis was tested in EAS users, as residual low-frequency hearing might imply survival of hair cells and hence better neural health in apical compared to basal cochlear regions. A total of 16 MED-EL EAS subjects participated, as well as a control group of 16 deaf cochlear implant users. The IPG effect on the AGF characteristics of slope, threshold, dynamic range, and stimulus level at 50% maximum eCAP amplitude (level 50% ) was investigated. AGF threshold and level 50% were significantly affected by the IPG in both EAS and control group. The magnitude of AGF characteristics correlated with electrode impedance and electrode-modiolus distance (EMD) in both groups. In contrast, the change of the AGF characteristics with increasing IPG was independent of these electrode-specific measures. The IPG effect on the AGF level 50% in both groups, as well as on the threshold in EAS users, correlated with the duration of hearing loss, which is a predictor of neural health. In EAS users, a significantly different IPG effect on level 50% was found between apical and medial electrodes. This outcome is consistent with our hypothesis that the influence of IPG effects on AGF characteristics provides a sensitive measurement and may indicate better neural health in the apex compared to the medial cochlear region in EAS users.