J Am Acad Audiol 2020; 31(01): 069-075
DOI: 10.3766/jaaa.18077
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

When Can Stable AutoNRT Thresholds be Expected? A Clinical Implication When Fitting Young Children

Andreas Björsne
*   Unit of Audiology, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
†   Hearing Organization, Habilitation & Health, Region Västra Götaland, Sweden
Lennart Magnusson
*   Unit of Audiology, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
‡   Department of ENT, Sahlgrenska University Hospital, Gothenburg, Sweden
› Author Affiliations
Further Information

Publication History

15 October 2018

Publication Date:
25 May 2020 (online)



Objective measurements are important for programming cochlear implants in young children and other individuals who cannot participate in behavioral measurements. AutoNRT, the automatic method used to record responses from the auditory nerve in the Cochlear Ltd., implant system, is often used as a basis for estimating the threshold level and comfort level (C-level) for these patients. However, it has not been sufficiently established if AutoNRT measurements remain consistent over time.


This study aimed to determine if/when AutoNRT thresholds stabilize.

Research Design:

The study design was a longitudinal prospective study.

Study Sample:

AutoNRT thresholds were obtained from 52 young children and 80 adults. All subjects received the same implant (CI24RE Contour Advance).

Data Collection and Analysis:

AutoNRT thresholds were measured on all intracochlear electrodes during the surgery and at the initial activation. During the following year, children were measured at 1, 3, 6, and 12 months, and adults were measured at 6 and 12 months. The results were analyzed based on mean values, correlation, and absolute mean differences.


There were large variations for all electrodes between the intraoperative and postoperative AutoNRT thresholds of both children and adults. For children, the thresholds were considered to be stable from 1 month. The correlations obtained between the last two measurements, 6 and 12 months, for both children and adults were generally high for all electrodes.


The present results demonstrate the importance of repeating the AutoNRT measurement postoperatively, at about 1 month after initial activation, to obtain reliable and stable thresholds for estimating the T- and C-level profiles.

This research was partly supported by a grant from Cochlear Nordic AB, Sweden.

Parts of the results in this study were presented at the World Congress of Audiology, Cape Town, South Africa, October 28–31, 2018.

Supplementary Material


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