Comparison of auditory perception between behavioural and objective MAPs in cochlear implant users: a systematic review.

Abstract

Objective: This systematic review (PROSPERO ID: CRD42024573626) explores whether objective MAPs result in better auditory perception than behavioural MAPs in cochlear implant (CI) users.

Design: Medline, Embase, Web of Science, CENTRAL, CINAHL Plus with Full Text, and Google Scholar were last searched in January 2026. English or French peer-reviewed full-length published articles comparing auditory perception between behavioural and objective MAPs in CI users were included. Their quality and level of evidence were independently assessed by two reviewers with the Quality Assessment Tool for Quantitative Studies and the 2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence.

Study sample: Twenty-six heterogeneous low-level studies were included (495 CI users).

Results: Most studies used non-validated tools and were non-double-blinded, imprecise and indirect. Four objective measures were used to guide fitting. The two main objective measures were the electrically evoked compound action potential (eCAP) thresholds and the electrically evoked stapedial reflex thresholds (eSRTs). ESRT-guided MAPs tended to yield significantly better auditory perception than behavioural MAPs in children, individuals with prelingual hearing loss, and short-term experienced CI users.

Conclusions: Further larger double-blinded high-level studies are needed to confirm the apparent efficacy of objective measures, particularly eSRTs, to guide fitting.