Desativação de eletrodos em usuários de implante coclear: impacto na percepção da fala e em medidas objetivas
Electrode deactivation in cochlear implant users: impact on speech perception and objective measures
Carlos Alberto Conceição Santana Júnior; Júlia Speranza Zabeu Fernandes; Luiz Fernando Manzoni Lourençone
Resumo
Objetivo: Verificar se a desativação de eletrodos em usuários de implante coclear resulta em modificações no reconhecimento de fala em silêncio e no ruído, bem como identificar se ocorrem alterações nas medidas elétricas e fisiológicas. Método: Estudo retrospectivo de prontuários de 46 usuários de implante coclear, de três fabricantes, submetidos à desativação de pelo menos um eletrodo. Foram analisados dados pré e pós-desativação referentes aos registros de programação, audiometria em campo livre (500, 1.000, 2.000 e 4.000 Hz) e testes de reconhecimento de sentenças gravadas em silêncio a 60 dB e com ruído competitivo a +10 dB de relação sinal-ruído. As medidas objetivas incluíram telemetria de impedância, reflexo estapediano eletricamente eliciado (eSRT) e potenciais de ação compostos evocados eletricamente (ECAP). As análises estatísticas utilizaram os testes de Wilcoxon, correlação de Spearman e qui-quadrado, com nível de significância de 5%. Resultados: Foram observadas correlações estatisticamente significativas nos limiares em 1.000 e 4.000 Hz nos 46 usuários estudados, porém sem repercussão funcional nas médias gerais ou na percepção de fala entre as avaliações pré e pós-desativação. As medidas objetivas mostraram alterações significativas, incluindo aumento de eletrodos com impedância alterada (2,2% para 13%; p = 0,009) e redução na presença de respostas de ECAP (53,8% para 28%). O eSRT apresentou número limitado de medidas, restringindo a análise. Conclusão: A desativação de eletrodos, quando clinicamente indicada, não comprometeu o desempenho auditivo funcional, embora tenha sido acompanhada de alterações elétricas e fisiológicas. Esses achados reforçam a necessidade de monitoramento abrangente e manejo individualizado.
Palavras-chave
Abstract
Purpose: To verify whether electrode deactivation in cochlear implant users results in modifications in silent and noisy speech recognition, as well as to identify whether changes occur in electrical and physiological measurements. Methods: Retrospective study of medical records of 46 cochlear implant users, from three manufacturers, who underwent deactivation of at least one electrode. Pre- and post-deactivation data relating to programming records, free-field audiometry (500, 1,000, 2,000 and 4,000 Hz) and sentence recognition tests recorded in silence at 60 dB and with competing noise at +10 dB signal-to-noise ratio. Objective measurements included impedance telemetry, electrically elicited stapedial reflex (eSRT) and electrically evoked compound action potentials (ECAP). Statistical analyses used the Wilcoxon test, Spearman correlation, and chi-square test, with a significance level of 5%. Results: Statistically significant correlations were observed in the thresholds at 1,000 and 4,000 Hz in the 46 users studied, but without functional impact on overall averages or speech perception between pre- and post-deactivation assessments. Objective measures showed significant changes, including an increase in electrodes with altered impedance (2.2% to 13%; p = 0.009) and a reduction in the presence of ECAP responses (53.8% to 28%). The eSRT had a limited number of measurements, restricting the analysis. Conclusion: Electrode deactivation, when clinically indicated, did not compromise functional auditory performance, although it was accompanied by electrical and physiological changes. These findings reinforce the need for comprehensive monitoring and individualized management.
Keywords
References
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» https://doi.org/10.1121/1.1381538
Submitted date:
08/05/2025
Accepted date:
02/18/2026
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