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ABSTRACT

The cortical auditory-evoked potential (CAEP) is an objective test that can be used to measure the benefit of cochlear implants (CIs) in adults and children. In this paper, we present a complex case of a 12-year-old Malay girl CI recipient who was born with Pendred syndrome and had progressive asymmetrical sensorineural hearing loss. We aim to share our experience in verifying the most comfortable level (MCL) of the CI device using the CAEP assessment, which was conducted in 2 sessions, i.e., before and after remapping. In this case, the child was unable to accurately judge the loudness of the stimulated channels during the conventional behavioural mapping, which also showed poor CAEP responses. Subsequently, the CI device was remapped using the electrically evoked stapedial reflex threshold (ESRT) approach. In addition to improved aided free-field thresholds, more robust CAEP waveforms were observed after the remapping procedure. Most of the CAEP peaks showed larger amplitudes and shorter latencies as a result of the ESRT-based map. This case report demonstrates the feasibility and usefulness of CAEP in verifying the CI mapping in a complex case.

Keywords: Cochlear implant, mapping, cortical auditory-evoked potential, speech stimuli, amplitude, latency