App-based daily self-measurement of impedance in cochlear implant users

IntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments,...

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Main Authors: Sarah Vormelcher, Cornelia Batsoulis, Daniel Kley, Michael Mair, Andreas Büchner
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/full
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author Sarah Vormelcher
Sarah Vormelcher
Cornelia Batsoulis
Daniel Kley
Michael Mair
Andreas Büchner
author_facet Sarah Vormelcher
Sarah Vormelcher
Cornelia Batsoulis
Daniel Kley
Michael Mair
Andreas Büchner
author_sort Sarah Vormelcher
collection DOAJ
description IntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments, offering limited temporal resolution of impedance changes. This study aimed to address this gap by implementing daily impedance monitoring using a smartphone app.MethodsA prospective study evaluated the usability of a research app for remote impedance measurements over 4 months following standard CI surgery with a MED-EL FLEX28 electrode. Impedance was recorded twice daily (morning and evening). The mean impedance across all electrode channels was analyzed for four postoperative time periods: early postoperative (up to day 10 postoperatively), late postoperative (from day 11 to ~4 weeks), intensive fitting (from ~4 weeks postoperatively to ~7 weeks) and regular hearing phase (from ~7 weeks to 4 months). Two CI fitting approaches were compared: activation during the early postoperative phase (early activation, EA) and activation during the intensive fitting phase (conventional activation, CA). Morning-to-evening differences in impedance (MED) were also examined.ResultsThe app demonstrated an overall usage rate of 66% (n = 28), indicating moderate-to-high adherence. Except for higher evening impedance values with CA in the late postoperative phase, no significant differences in mean impedance between the fitting approaches were observed (EA: 6.46 kΩ, n = 11; CA: 7.82 kΩ, n = 11; p = 0.04). Significant differences in MED were found during the early postoperative phase (EA: 0.06 kΩ, n = 8; CA: −0.18 kΩ, n = 10; p = 0.04) and the late postoperative phases (EA: 0.85 kΩ, n = 11; CA: 0.03 kΩ, n = 11; p < 0.001).ConclusionRemote impedance measurements via the app can be made over an extended postoperative period. The increased measurement frequency allowed for detailed characterization of impedance dynamics, particularly around the onset of electrical stimulation. No clinically relevant difference in mean impedance was found between EA and CA groups. Daily fluctuations showed consistently lower evening values after stimulation onset. These findings highlight the potential value of this approach for enhancing postoperative CI management.
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spelling doaj-art-5c45f375afd34e46ae20d255d31ca5a62025-08-20T03:31:44ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16180311618031App-based daily self-measurement of impedance in cochlear implant usersSarah Vormelcher0Sarah Vormelcher1Cornelia Batsoulis2Daniel Kley3Michael Mair4Andreas Büchner5Department of Otorhinolaryngology, Hannover Medical School, Hannover, GermanyMED-EL Research Center, MED-EL Medical Electronics GmbH, Hannover, GermanyMED-EL Research Center, MED-EL Medical Electronics GmbH, Hannover, GermanyDepartment of Otorhinolaryngology, Hannover Medical School, Hannover, GermanyMED-EL R&D, MED-EL Medical Electronics GmbH, Innsbruck, AustriaDepartment of Otorhinolaryngology and Cluster of Excellence “Hearing4all”, Hannover Medical School, Hannover, GermanyIntroductionImpedance telemetry measurements in cochlear implant (CI) recipients are commonly used to assess CI electrode functionality and provide valuable insights into inner ear conditions. However, these measurements usually take place only during surgery and at clinical follow-up appointments, offering limited temporal resolution of impedance changes. This study aimed to address this gap by implementing daily impedance monitoring using a smartphone app.MethodsA prospective study evaluated the usability of a research app for remote impedance measurements over 4 months following standard CI surgery with a MED-EL FLEX28 electrode. Impedance was recorded twice daily (morning and evening). The mean impedance across all electrode channels was analyzed for four postoperative time periods: early postoperative (up to day 10 postoperatively), late postoperative (from day 11 to ~4 weeks), intensive fitting (from ~4 weeks postoperatively to ~7 weeks) and regular hearing phase (from ~7 weeks to 4 months). Two CI fitting approaches were compared: activation during the early postoperative phase (early activation, EA) and activation during the intensive fitting phase (conventional activation, CA). Morning-to-evening differences in impedance (MED) were also examined.ResultsThe app demonstrated an overall usage rate of 66% (n = 28), indicating moderate-to-high adherence. Except for higher evening impedance values with CA in the late postoperative phase, no significant differences in mean impedance between the fitting approaches were observed (EA: 6.46 kΩ, n = 11; CA: 7.82 kΩ, n = 11; p = 0.04). Significant differences in MED were found during the early postoperative phase (EA: 0.06 kΩ, n = 8; CA: −0.18 kΩ, n = 10; p = 0.04) and the late postoperative phases (EA: 0.85 kΩ, n = 11; CA: 0.03 kΩ, n = 11; p < 0.001).ConclusionRemote impedance measurements via the app can be made over an extended postoperative period. The increased measurement frequency allowed for detailed characterization of impedance dynamics, particularly around the onset of electrical stimulation. No clinically relevant difference in mean impedance was found between EA and CA groups. Daily fluctuations showed consistently lower evening values after stimulation onset. These findings highlight the potential value of this approach for enhancing postoperative CI management.https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/fullcochlear implantdaily impedance measurementelectrode impedanceelectrical stimulationremote impedance monitoringimpedance fluctuation
spellingShingle Sarah Vormelcher
Sarah Vormelcher
Cornelia Batsoulis
Daniel Kley
Michael Mair
Andreas Büchner
App-based daily self-measurement of impedance in cochlear implant users
Frontiers in Neurology
cochlear implant
daily impedance measurement
electrode impedance
electrical stimulation
remote impedance monitoring
impedance fluctuation
title App-based daily self-measurement of impedance in cochlear implant users
title_full App-based daily self-measurement of impedance in cochlear implant users
title_fullStr App-based daily self-measurement of impedance in cochlear implant users
title_full_unstemmed App-based daily self-measurement of impedance in cochlear implant users
title_short App-based daily self-measurement of impedance in cochlear implant users
title_sort app based daily self measurement of impedance in cochlear implant users
topic cochlear implant
daily impedance measurement
electrode impedance
electrical stimulation
remote impedance monitoring
impedance fluctuation
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1618031/full
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