Automated detection of electrically evoked stapedius reflexes (eSR) during cochlear implantation.
Open accessAbstract
INTRODUCTION: In cochlear implantation, objective fitting methods are needed to optimize audiological results in small children or patients with poor compliance. Intraoperatively measured electrically evoked stapedius reflexes (eSR) can be used as a marker for the patient's discomfort level. The aim of this study was to develop and evaluate an automated detection method for eSR and to compare it to the detection rate of the surgeon and independent observers. METHODS: Cochlear implantation using a fully digital surgical microscope was performed. Movements of the stapedius tendon were recorded and analyzed by means of computer vision technique. Differences in eSR elicited by stimulating electrodes at different cochlear locations (basal, middle and apical) were analyzed. The eSR detection rate of the image processing algorithm was compared to the surgeon's detection rate and to those of two less experienced observers. RESULTS: A total of 387 electrically impulses were applied. The stimulation of middle turn electrodes showed significantly higher detection rates (50.4%) compared to the basal (40.0%; p = 0.001) and apical (43.6%; p = 0.03) turn. The software identified significantly more of the applied stimuli (58.4%) compared to the surgeon (46.3%; p = 0.0007), the intermediate observer (37.7%; p < 0.0001) and the unexperienced observer (41.3%; p < 0.0001). CONCLUSION: The feasibility of an automated intraoperative software-based detection of eSR is demonstrated. By improving the eSR detection methods and their clinical applicability, their utility in objective cochlear implant fitting may be substantially increased.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The automatic tuning of stimulation thresholds in cochlear implants can be done by measuring the contraction of the stapedius muscle.
“Thus, the automatic tuning of stimulation thresholds in cochlear implants can be done by measuring the contraction of the stapedius muscle.”
From Toward a personalized closed-loop stimulation of the visual cortex: Advances and challenges (2022) · cites this paper as Weiss et al., 2021
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Smoothing and Differentiation of Data by Simplified Least Squares Procedures.
Savitzky, A., & Golay, M. J. E. (1964) · Analytical Chemistry · doi:10.1021/ac60214a047 · Cited by 21,904 · see citing works
(1981) · Cited by 11,963 · see citing works
Robust wide-baseline stereo from maximally stable extremal regions
Matas, J., Chum, O., Urban, M., & Pajdla, T. (2004) · Image and Vision Computing · doi:10.1016/j.imavis.2004.02.006 · Cited by 3,683 · see citing works
THRESHOLD OF REFLEX CONTRACTIONS OF MUSCLES OF MIDDLE EAR AND RECRUITMENT OF LOUDNESS
Metz, O. (1952) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.1952.00710010550003 · Cited by 212 · see citing works
The Scope Of Three-Dimensional Digital Visualization Systems In Vitreoretinal Surgery
Agranat, J. S., Miller, J. B., Douglas, V. P., Douglas, K. A. A., Marmalidou, A., Cunningham, M. A., & Houston, S. K. S. (2019) · Clinical ophthalmology · doi:10.2147/opth.s213834 · Cited by 118 · see citing works
Electrically Elicited Stapedius Reflex in Cochlear Implant Patients
Battmer, R. D., Laszig, R., & Lehnhardt, E. (1990) · Ear and Hearing · doi:10.1097/00003446-199010000-00008 · Cited by 75 · see citing works
Measurement of Comfort Levels by Means of Electrical Stapedial Reflex in Children
Bresnihan, M., Norman, G., Scott, F., & Viani, L. G. (2001) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.127.8.963 · Cited by 74 · see citing works
Acoustic reflex frequency selectivity in single stapedius motoneurons of the cat
Kobler, J. B., Guinan, J. J., Vacher, S. R. W., & Norris, B. E. (1992) · Journal of Neurophysiology · doi:10.1152/jn.1992.68.3.807 · Cited by 54 · see citing works
Almqvist, B., Harris, S., & Shallop, J. K. (2000) · International Journal of Audiology · doi:10.3109/00206090009073067 · Cited by 22 · see citing works
Pau, H. W., Ehrt, K., Just, T. H., Sievert, U., & Dahl, R. (2010) · The Journal of Laryngology & Otology · doi:10.1017/s0022215110002392 · Cited by 19 · see citing works
de Andrade, K. C. L., Muniz, L. F., Menezes, P. D. L., Neto, S. D. S. C., Carnaúba, A. T. L., & Leal, M. D. C. (2017) · Journal of the American Academy of Audiology · doi:10.3766/jaaa.16117 · Cited by 18 · see citing works
Schultz, B., Beger, F. A., Weber, B. P., Niclaus, O., Lüllwitz, E., Grouven, U., & Schultz, A. (2003) · Pediatric Anesthesia · doi:10.1046/j.1460-9592.2003.01154.x · Cited by 17 · see citing works
Pau, H. W., Zehlicke, T., Sievert, U., Schaudel, D., Behrend, D., & Dahl, R. (2008) · Otology & Neurotology · doi:10.1097/mao.0b013e31818a0898 · Cited by 17 · see citing works
Almqvist, B., Harris, S., & Shallop, J. K. (2000) · PubMed · Cited by 15 · see citing works
Hörimplantate im Zeitalter der Digitalisierung
Olze, H., Uecker, F. C., Häußler, S. M., Knopke, S., Szczepek, A. J., & Gräbel, S. (2019) · Laryngo-Rhino-Otologie · doi:10.1055/a-0755-2811 · Cited by 15 · see citing works
Karataş, E., Deniz, M., Bağlam, T., Durucu, C., Baysal, E., & Kanlı́kama, M. (2011) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2011.06.002 · Cited by 12 · see citing works
Auditory steady state response in sound field
Hernández-Pérez, H., & Torres-Fortuny, A. (2012) · International Journal of Audiology · doi:10.3109/14992027.2012.727103 · Cited by 11 · see citing works
Measuring the Electrical Stapedius Reflex with Stapedius Muscle Electromyogram Recordings
Clement, R. S., Carter, P. M., & Kipke, D. R. (2002) · Annals of Biomedical Engineering · doi:10.1114/1.1454132 · Cited by 11 · see citing works
Rajati, M., Ghassemi, M. M., Bakhshaee, M., Tale, M. R., & Tayarani, H. (2013) · Auris Nasus Larynx · doi:10.1016/j.anl.2013.10.015 · Cited by 10 · see citing works
Weiss, B. G., Söchting, F., Bertlich, M., Busch, M., Blum, J., Ihler, F., & Canis, M. (2017) · Otology & Neurotology · doi:10.1097/mao.0000000000001611 · Cited by 9 · see citing works
Jackler, R. K., & Jan, T. A. (2019) · The Journal of Laryngology & Otology · doi:10.1017/s0022215119001531 · Cited by 9 · see citing works
Pau, H. W., Grünbaum, A., Ehrt, K., Dahl, R., Just, T., & van Rienen, U. (2013) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-013-2543-8 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Toward a personalized closed-loop stimulation of the visual cortex: Advances and challenges
Grani, F., Soto-Sánchez, C., Fimia, A., & Fernández, E. (2022) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2022.1034270 · Cited by 16 · see citing works
Feasibility of Obtaining Intraoperative Electrically Evoked Stapedial Reflex Thresholds ( eSRT )
Chau, I. J., Cunningham, E. P., Bornstein, R., Albinus, R., & Stidham, K. R. (2025) · The Laryngoscope · doi:10.1002/lary.32226 · Cited by 1 · see citing works
Müller, A., Blümer, M., Dziemba, O. C., Elsholz, A., Fröhlich, L., Hoppe, U., Polterauer, D., Rahne, T., Steffens, T., Walger, M., et al. (2025) · HNO · doi:10.1007/s00106-025-01629-w · Cited by 1 · see citing works
Cochlear Implantation: Perspectives on Audiological Evaluations
Cesur, S., Çiprut, A. A., & Rubinstein, J. T. (2024) · Comprehensive ENT · doi:10.1007/978-3-031-77370-9_18 · Cited by 1 · see citing works
Кохлеарная имплантация у новорожденных: сложности и особенности
Егоров, А. И., & Glukhovskiy, Е. М. (2021) · Естественные и Технические Науки · doi:10.37882/2223-2966.2021.04-2.07
Ghoniem, M. M. R., El-Sharabasy, A. E., Shabana, Y. K., & Ismail, E. I. (2023) · Mansoura Medical Journal · doi:10.58775/2735-3990.1381
Desoyer, C., Proksch, J., Berger, P., & Baumgärtner, C. (2024) · International Symposium on Medical Information Processing and Analysis (SIPAIM) · doi:10.1109/sipaim62974.2024.10783573
Diagnosis and Management of Cochlear Implant Malfunctions
Zwolan, T. A., & Stach, C. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-67188-3_12
Mękarska, M., Wojciechowski, T., Niemczyk, K., & Bartoszewicz, R. (2025) · Anatomical Science International · doi:10.1007/s12565-025-00827-4
Müller, A., Blümer, M., Dziemba, O. C., Elsholz, A., Fröhlich, L., Hoppe, U., Polterauer, D., Rahne, T., Steffens, T., Walger, M., et al. (2025) · HNO · doi:10.1007/s00106-025-01628-x
Letter to the Editor Concerning MacDonald, Gifford, et al. (2025)
Todd, N. W., & Fainberg, J. C. (2025) · Otology & Neurotology · doi:10.1097/mao.0000000000004771
Cunningham, E. P., Chau, I. J., Bornstein, R., Albinus, R., Shah, P. S., & Stidham, K. R. (2026) · Cochlear Implants International · doi:10.1080/14670100.2026.2739687
- Authors
- Weiss, N. M., Óvári, A., Oberhoffner, T., Demaret, L., Bicer, A., Schraven, S., Ehrt, K., Dahl, R., Schneider, A., & Mlynski, R.
- Affiliations
- Universitätsmedizin Rostock (DE)
- Asklepios Klinik St. Georg (DE)
- Arri (Germany) (DE)
- Corresponding author
- Mlynski, Robert
- ORCID
- Venue
- European Archives of Oto-Rhino-Laryngology
- Published
- 2020-08-03
- Volume
- 278
- Issue
- 6
- Pages
- 1773-1779
- ISSN
- 0937-4477 (ISSN-L)
- 1434-4726
- PMC
- PMC8131305
- OpenAlex
- W3047266736
- Cited by
- 12
- References
- 22
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Archives of Oto-Rhino-Laryngology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Keywords
- cochlear implantation, intraoperative monitoring, computer vision, patient discomfort
- MeSH terms
- Auditory Threshold, Child, Cochlear Implants, Electric Stimulation, Humans, Reflex, Acoustic, Stapedius, Cochlear Implantation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
