Association of AutoART eCAP thresholds with behavioral THR and MCL in pediatric cochlear implant users

PURPOSE: This study investigated the relationship between electrically evoked compound action potential (eCAP) thresholds obtained using the Automatic ART (AutoART) method and behavioral threshold level (THR), maximum comfort level (MCL), and electrode impedance values in pediatric cochlear implant (CI) users. Differences across electrode regions and the effects of electrode type, implant model, implant ear side, and gender were also examined. METHODS: Thirty pediatric CI users aged 7-18 years with MED-EL implants and reliable eCAP responses from all electrodes were included. eCAP thresholds were obtained automatically using the AutoART method with MAESTRO 11.0. Behavioral THR and MCL values were determined using standard programming procedures, and impedance values were recorded via telemetry. RESULTS: eCAP thresholds, THR, and MCL values increased significantly from apical to basal electrodes. eCAP thresholds were positively correlated with behavioral THR and MCL across all regions. Regression analyses indicated that eCAP thresholds were the strongest predictors of both THR and especially MCL, while impedance did not significantly contribute. The strongest correlations were observed in the apical region. CONCLUSION: AutoART-based eCAP measurements provide a reliable objective indicator supporting behavioral programming in pediatric CI users.