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ECAPs are the summary of multiple neurons’ spikes which could be recorded by a bidirectional stimulation-recording system via the cochlear implant, with the artifact elimination paradigms of forward-masking subtraction paradigm or alternating polarity paradigm. Three kinds of FDA approved cochlear implants support ECAP testing. This article is to summarize the clinical application of ECAP test. ECAP test after insertion of electrode during implant operation has been widely used during cochlear implant surgery. In recent years, ECAP thresholds are also used to estimate the T levels and C levels helping programming. However, correlation between ECAP thresholds and psychophysical thresholds is affected by many factors. So far, ECAPs cannot yet be a good indicator of post-operative hearing and speech performance.
