Cochlear Implants International[JOURNAL]
Sun
200 papers
Importance of early access to language: theory of mind in school-aged children with cochlear implants.
Burum K, Lyxell B, Sundström S
Cochlear Implants Int · 2025 May · PMID 40607734 · Publisher ↗
OBJECTIVE: This study aimed to investigate the theory of mind (ToM) understanding in early implanted school-aged children in Norway, comparing their performance to that of typically developing (TD) peers, and considering...
OBJECTIVE: This study aimed to investigate the theory of mind (ToM) understanding in early implanted school-aged children in Norway, comparing their performance to that of typically developing (TD) peers, and considering age at implantation and hearing age. METHODS: Twelve 8-12-year-old children, who received cochlear implants (CI) before 18 months of age, were recruited. Ten of them were included in early speech-language and listening intervention. The control group comprised 22 TD peers. All children underwent tests evaluating cognitive and affective ToM. Bayesian methods were used to examine group differences in cognitive and affective ToM, and the relationships between ToM variables and implantation and hearing age. RESULTS: The children with CI were more likely to perform comparably to TD peers on both affective and cognitive ToM, than differing from them. The relationship between affective ToM and implantation age was more likely to be present than absent, while a converse correlation pattern was found for cognitive ToM and implantation and hearing age. The relationship between affective ToM and hearing age was inconclusive, suggesting more data is needed. CONCLUSION: Our findings underscore the importance of early implantation in supporting ToM progress, aligning with the sensitive period account. Missing the sensitive period for optimal ToM development could lead to lasting ToM developmental gaps. Therefore, to minimize potential delays, it might be essential to provide CI and speech-language and listening intervention early in life. These measures facilitate the social interactions with caregivers that are critical for fostering ToM development.
Auditory perception and speech recognition outcomes in Syrian refugee children with cochlear implants.
Deniz H
Cochlear Implants Int · 2025 May · PMID 40600633 · Publisher ↗
OBJECTIVE: Limited studies have examined the prevalence of hearing loss among Syrian refugees living in Turkey, where it is anticipated to be higher compared to the general population. 430,148 Syrian refugees live in Gaz...
OBJECTIVE: Limited studies have examined the prevalence of hearing loss among Syrian refugees living in Turkey, where it is anticipated to be higher compared to the general population. 430,148 Syrian refugees live in Gaziantep province, where this study was conducted. This study aimed to examine the auditory perception, word and sentence comprehension, and speech recognition outcomes of Syrian refugee children who underwent cochlear implantation (CI). DESIGN: Among 960 individuals who underwent CI surgery between August 2015 and April 2023, 135 (14.6%) were Syrian refugee children. The Arabic version of the Evaluation of Auditory Responses to Speech (EARS) test battery was used to assess language development and auditory perception levels of the Syrian refugees. STUDYSAMPLE: Data on auditory perception and speech recognition from 30 Syrian refugee children with CI were analyzed. RESULTS: CI was performed in Syrian refugee children at an average age of 39.57 ± 17.56 months. Findings of the study showed that the socioeconomic conditions of the Syrian refugee group were quite limited, with 93.33% of participants not receiving regular special education. It was observed that the age of access to CI was delayed for Syrian refugee children. EARS test scores for Syrian refugee CI users were significantly lower than normative values ( < 0.05). CONCLUSION: Despite using CIs, many Syrian refugee children demonstrated lower-than-expected performance in auditory and language development, likely owing to socioeconomic disadvantages, lack of access to special education, and delayed implantation. These findings highlight the need for early diagnosis, timely implantation, and effective rehabilitation programs for refugee children.
Caring for a child with a cochlear implant: A narrative review of the challenges, needs, and potential digital options for parents of children with cochlear implants.
Delgama D, Galvin K, Gray K … +1 more , Leigh J
Cochlear Implants Int · 2025 May · PMID 40571401 · Publisher ↗
OBJECTIVES: The purpose of this narrative review is to understand the challenges faced by, and needs of, parents of children who are cochlear implant candidates or recipients according to parent reports. Additionally, it...
OBJECTIVES: The purpose of this narrative review is to understand the challenges faced by, and needs of, parents of children who are cochlear implant candidates or recipients according to parent reports. Additionally, it seeks to identify potential digital interventions that could provide meaningful support for this population. METHODS: A literature search was conducted across three key areas: challenges faced by parents, parental needs, and current digital interventions. Relevant studies were reviewed, and key themes were extracted. RESULTS: A total of 131 studies were included in the review. There were 25 studies exploring pre-implantation challenges, 30 studies exploring post-implantation challenges, 27 studies exploring parental needs and 58 studies exploring existing digital interventions. CONCLUSION: Parents face significant challenges during both the pre-implantation and post-implantation stages. Pre-implantation challenges include fears about the surgical risks and outcomes, financial costs, choosing a communication modality for their child, stigma, and delays in referrals to services. Post-implantation challenges primarily relate to managing expectations, cochlear implant device maintenance, education, long-term costs and the social implications of the cochlear implant for the child. Parental needs during both stages include information and support from peers. Existing digital interventions for parents of children with health conditions, such as online support groups, mobile health apps, and telemedicine services, show promise for addressing these needs and could be adapted for parents navigating the cochlear implantation process.
The benefit of bilateral cochlear implants in adults with bilateral sensorineural hearing loss: a systematic review and meta-analysis.
Bance M, Costales Marcos M, Guignard J … +6 more , Huinck W, Killian M, Lionikaite V, Quadri H, Rand K, Sivonen V
Cochlear Implants Int · 2025 May · PMID 40566884 · Publisher ↗
OBJECTIVES: To perform a systematic literature review (SLR) on hearing and quality-of-life (QoL) benefits of bilateral versus unilateral cochlear implants (CIs) in adults with sensorineural hearing loss (SNHL), and to qu...
OBJECTIVES: To perform a systematic literature review (SLR) on hearing and quality-of-life (QoL) benefits of bilateral versus unilateral cochlear implants (CIs) in adults with sensorineural hearing loss (SNHL), and to quantify benefits through a meta-analysis when feasible. METHODS: Embase, MEDLINE, and Cochrane were searched from January 2005-June 2022. Eligible studies presented effectiveness of CIs and/or QoL of adult CI users. Articles that presented numerical point estimates for, or numerical difference between, bilateral and unilateral CI, and measures of uncertainty were considered for meta-analysis, with data analyzed using fixed- and random-effects models. RESULTS: Thirty-five articles were included. There was a trend of significant improvement with bilateral CIs in sound localization and binaural redundancy. A meta-analysis confirmed statistically significant benefits in speech perception (in quiet, 12.6 percentage point [95% confidence interval: 7.1, 18.1] improvement; in noise, improvement in speech reception threshold of 1.5 dB signal-to-noise ratio [-1.5 dB; 95% confidence interval: -2.5, -0.4]). There were beneficial trends of bilateral CIs regarding head-shadow effect and binaural release from masking. Significant improvements in hearing-specific QoL were observed; generic QoL was mostly unchanged. DISCUSSION: Bilateral CIs provide audiological benefit over unilateral CI, resulting in hearing-specific QoL improvements. Lack of changes in generic QoL may reflect that instrument domains are insensitive to hearing-related changes when going from unilateral to bilateral CIs. Meta-analyses could not be performed for all hearing and QoL outcomes owing to variability in methodologies across studies. CONCLUSIONS: These findings should be used to inform clinical decision-making to ensure the best outcomes for adults with bilateral SNHL.
Intra and postoperative electrocochleography in cochlear implant recipients: retrospective chart review.
Ordóñez Ordóñez LE, Angulo Martinez ES, Vanegas SC … +4 more , Hernández EC, Peroza Fuentes E, Dwyer RT, Martinho-Carvalho AC
Cochlear Implants Int · 2025 Mar · PMID 40528362 · Publisher ↗
OBJECTIVES: The purpose of the study was (1) to retrospectively analyze ECochG data and compare it with the current literature. (2) to explore the relationship between ECochG and post-op audiological assessments. METHODS...
OBJECTIVES: The purpose of the study was (1) to retrospectively analyze ECochG data and compare it with the current literature. (2) to explore the relationship between ECochG and post-op audiological assessments. METHODS: This retrospective study included all patients with intraoperative and postoperative ECochG measurements and postoperative audiologic testing. ECochG were performed during CI insertion regardless of the preoperative hearing status. Preoperative and postoperative assessments were extracted from the medical records. RESULTS: A total of 35 patients (42 ears) met the inclusion criteria. Intra-op ECochG response was measurable in 17 of 42 ears (40.5%). The mean peak amplitude found was 103.3 µvolts. The type of electrode array was not associated with the ECochG amplitude ( = .630). Post-op ECochG thresholds were significantly correlated with behavioral thresholds after a month of CI implantation ( < 0.05). CONCLUSIONS: ECochG responses were measurable in individuals with mean preop pure tone thresholds of 66 dB HL at 250 Hz, 77 dB HL at 500 Hz, 84 dB HL at 1 kHz and 92 dB HL at 2kHz. The type of electrode was not associated with the ECochG peak nor with greater preservation of residual hearing. Post-op ECochG thresholds were significantly correlated with post-op thresholds.
The impact of prematurity on cochlear implant outcomes: A case-control study.
Tessler I, Adler Y, Gecel NA … +6 more , Symon N, Yakir Z, Henkin Y, Shapira Y, Carmel E, Wolfovitz A
Cochlear Implants Int · 2025 Mar · PMID 40470928 · Publisher ↗
OBJECTIVE: Despite a higher prevalence of hearing loss in preterm-born infants, cochlear implantation (CI) outcome remains underexplored in this unique subpopulation. We aimed to compare long-term hearing outcomes betwee...
OBJECTIVE: Despite a higher prevalence of hearing loss in preterm-born infants, cochlear implantation (CI) outcome remains underexplored in this unique subpopulation. We aimed to compare long-term hearing outcomes between preterm- and term-born infants undergoing CI and identify prognostic factors of hearing outcomes among preterm infants post-CI. METHODS: This retrospective case-control study compared preterm infants (study group) with two control groups who underwent CI: One group of term infants was matched for hearing loss etiology and the other group was comprised of term infants with a genetic etiology [connexin-26 (GJB2)], the benchmark for favorable CI outcomes. Subgroup analyses were based upon birth weight and gestational age. Primary outcomes included long-term speech reception threshold (SRT) and monosyllabic word identification (HAB) scores. RESULTS: A total of 161 implanted ears were included: 35 (22%) in the study group, 63 (39%) in the etiology-matched control group, and 63 (39%) in the GJB2 group. SRT was significantly lower in the GJB2 group compared to the study group ( = 0.007) but not between the study and the etiology-matched control group ( = 0.79). HAB scores were comparable among the three groups. A subgroup analysis revealed significant differences in word identification by birth weight, particularly in the <1000 g group. A linear mixed model analysis indicated significant improvements in HAB scores over time for all groups ( < 0.0001), with comparable HAB progress ( = 0.98). CONCLUSION: Our findings suggest that prematurity does not significantly impact speech perception outcomes among CI recipients. Low birth weight in preterm infants, however, emerged as a negative prognostic factor for language perception outcomes.
Reading abilities of adolescents with cochlear implants: the role of early speech perception in a longitudinal study.
Davidson LS, Geers AE, Uchanski RM
Cochlear Implants Int · 2025 Mar · PMID 40443258 · Full text
OBJECTIVE: To examine reading skills of adolescents who use cochlear implants (CIs) and who were implanted early. Three questions are asked: (1) Do these pediatric CI recipients read at age-appropriate levels at adolesce...
OBJECTIVE: To examine reading skills of adolescents who use cochlear implants (CIs) and who were implanted early. Three questions are asked: (1) Do these pediatric CI recipients read at age-appropriate levels at adolescence, as they had done at elementary-ages (Grantham et al. [2022]. Effects of segmental and suprasegmental speech perception on reading in pediatric cochlear implant recipients. , (9), 3583-3594. https://doi.org/10.1044/2022_JSLHR-22-00035 )? (2) Are the previously documented effects of early segmental and suprasegmental speech perception on elementary-age reading skills obtained for adolescent reading skills? (3) Do the effects on adolescent reading differ for early speech perception versus elementary-age speech perception? DESIGN: Eighty-six orally educated children with a mean age of CI of 2 years completed a standardized reading comprehension test at elementary ages (7-11 years) and at adolescent ages (11-16 years). They completed speech perception tests when they were 5-9 years old (early) and again at 7-11 years of age (elementary-age). Reading comprehension scores from elementary and adolescent ages were compared, and the effects of early and elementary-age speech perception on adolescent reading were examined. RESULTS: The mean reading passage comprehension standard score was within the normative range for typically hearing age-mates at both elementary-age and adolescent testing. Early suprasegmental speech perception was the only significant speech perception predictor of adolescent reading skills, after controlling for demographic and audiological variables. CONCLUSIONS: These data bolster the recent literature reporting good reading skills, on average, for children who received early CIs and highlight the long-term benefits of good early suprasegmental speech perception skills. Both segmental and suprasegmental perception should be included in audiological candidacy criteria and educational intervention for children with CIs.
Cryoablation of the superficial cervical plexus for post cochlear implantation lesser occipital neuralgia.
Lichtenstein GR, Mwassi B, Wolfovitz A … +3 more , Levitan MN, Morag O, Shapira Y
Cochlear Implants Int · 2025 Mar · PMID 40406902 · Publisher ↗
OBJECTIVE AND IMPORTANCE: Chronic pain following cochlear implantation (CI) is a notable complication that can lead to device explantation. This case report describes the successful treatment of post-CI lesser occipital...
OBJECTIVE AND IMPORTANCE: Chronic pain following cochlear implantation (CI) is a notable complication that can lead to device explantation. This case report describes the successful treatment of post-CI lesser occipital neuralgia using cryoablation of the superficial cervical plexus (SCP). CLINICAL PRESENTATION: A 25-year-old female patient developed localized pain following CI reimplantation, presenting with allodynia and dysesthesia in the left lesser occipital nerve distribution. After a positive diagnostic SCP block providing temporary relief, ultrasound-guided cryoablation was performed. CONCLUSION: The procedure resulted in complete pain resolution and anesthesia in the distribution of the lesser occipital, greater auricular, and transverse cervical nerves. While pain recurrence occurred after seven months necessitating repeat treatment, the intervention proved to be a safe and effective management strategy for post-CI neuralgia. This case demonstrates that SCP cryoablation may offer a viable, minimally invasive solution for patients experiencing post-CI neuralgic pain, with the potential for repeated applications as needed.
Hospital service utilisation and treatment costs before and after cochlear implantation in adults with hearing loss: a retrospective cohort study.
Okuba T, Lystad RP, Boisvert I … +6 more , McMaugh A, Moore RC, Wolnizer P, Chow C, Walsan R, Mitchell R
Cochlear Implants Int · 2025 Mar · PMID 40383913 · Publisher ↗
OBJECTIVE: Hearing loss can lead to a higher health service use which may be reduced by using hearing technology. This study aimed to examine pre- and post-cochlear implant hospital service use and treatment costs of adu...
OBJECTIVE: Hearing loss can lead to a higher health service use which may be reduced by using hearing technology. This study aimed to examine pre- and post-cochlear implant hospital service use and treatment costs of adults with hearing loss. METHODS: A retrospective cohort study was conducted using linked hospital admission and mortality data in New South Wales, Australia. Adults aged ≥18 years who received a cochlear implant between 2015- and 2017 were included. Outcomes included all-cause hospital admissions, total hospital length of stay (LOS) and treatment costs in 4 years prior to- and 4 years post-implant. A negative binomial regression model was used to examine characteristics associated with hospitalisation. RESULTS: There were 1159 individuals who received a cochlear implant between 2015- and 2017. Adults aged ≥65 years had a higher number of all-cause hospitalisations post-implant (65.7%) compared with pre-implant (57.9%). The median hospital LOS was 5.0 days (IQR 13.0) pre- and 6.0 days (IQR 19.0) post-implant. Being of aged ≥65 years, having comorbidity and a fall-related injury were associated with both pre- and post-implant hospitalisations. Having a mental health disorder was additionally associated with pre-implant hospitalisations. The median treatment costs were AUD$10,790 (IQR 27,595) pre- and AUD$9,444 (IQR 31,945) post-implant. CONCLUSION: Adults aged ≥65 years, with comorbidities, fall-related injuries and mental health disorders faced higher hospitalisation. Adults encountered higher treatment costs pre-implantation, but these costs decreased post-implant. This suggests a need for tailored pre- and post-operative care strategies to mitigate risks and manage costs effectively.
Cochlear implant services for Spanish speaking patients: language access and organizational health literacy of programs in the United States of America.
Ullauri A, Kramer T, Shafiro V
Cochlear Implants Int · 2025 Mar · PMID 40375061 · Publisher ↗
OBJECTIVE: To examine the accessibility of online information about cochlear implant (CI) services for Spanish speakers and evaluate organizational health literacy practices in CI programs in the United States (USA). MET...
OBJECTIVE: To examine the accessibility of online information about cochlear implant (CI) services for Spanish speakers and evaluate organizational health literacy practices in CI programs in the United States (USA). METHOD: From a list provided by Cochlear, CI programs working with at least two of three CI manufacturers were identified in eight states. Selected states had the highest and lowest Hispanic populations in each of the four US geographic regions. Online information access was evaluated based on whether programs' website links were a) listed on manufacturers' 'Find-a-Clinic' tabs, b) led directly to the CI program website, c) provided information about CIs in Spanish, and d) the readability level of such information. To examine language access, researchers determined if listed programs' phone numbers connected to the department providing CI services and the availability of Spanish speaking schedulers, audiologists, ENT surgeons, and professional interpreters (PIs). RESULTS: 122 CI programs met the inclusion criteria. Only 4-9% of listed programs had a link connecting directly to the CI program's website, and only 11% had Spanish-language CI information. Spanish text averaged 10th grade readability (Flesch-Kincaid). Phone contacts showed 78% of numbers connected directly to the ENT/Audiology department, while only 27% offered an initial Spanish option. PIs were available in 68% of programs. CONCLUSIONS: Results indicate reduced language access for Spanish speakers seeking CI services in the USA, exemplified by limited access to PIs and bilingual providers, insufficient availability of information about CIs on programs' websites, and low organization health literacy practices in CI programs.
Customized strategies for managing cochlear implant stimulation side effects.
Wang X, Tran P, Kapolowicz MR … +5 more , Lu T, Stickney G, Starr A, Djalilian H, Zeng FG
Cochlear Implants Int · 2025 Mar · PMID 40178190 · Full text
OBJECTIVES: Cochlear implants restore functional hearing but may cause side effects like facial nerve stimulation, sound sensitivity or reactive tinnitus. The present study aimed to establish a general framework for opti...
OBJECTIVES: Cochlear implants restore functional hearing but may cause side effects like facial nerve stimulation, sound sensitivity or reactive tinnitus. The present study aimed to establish a general framework for optimizing stimulation parameters to manage these side effects while maximizing speech perception performance. A second objective was to understand how side effect origins impact treatment outcomes. METHODS: Eight adult cochlear implant subjects had intolerable side effects that rendered device usage difficult or even impossible. New maps were created by reducing stimulation levels, increasing pulse duration, reducing stimulation rate, altering channel gains and frequency maps, deactivating problematic electrodes, or a combination of the above. Outcomes were measured in terms of side effect reduction and changes in speech performance. RESULTS: Facial nerve stimulation was reduced or eliminated in five of five subjects. Sound hypersensitivity was eliminated in two of two subjects. Tinnitus was alleviated in three of four subjects, while the remaining one with cerebellar malformation experienced no change. Speech performance was either maintained or improved in all subjects. Except for the subject with cerebellar malformation who chose to explant the device, all subjects were able to use the implant effectively without bothersome side effects. DISCUSSION: Facial nerve stimulation is usually related to electric current spread on the same side, which can be effectively managed by customized strategies. In contrast, the origins of sound sensitivity and reactive tinnitus are more variable and likely more difficult to manage. CONCLUSION: Customized mapping can alleviate cochlear implant side effects without compromising speech performance.
Temporal bone image quality in CBCT: Device and protocol variations.
Razavi SH, Poormohammadi M, Ansarilari A
Cochlear Implants Int · 2025 Jan · PMID 40157748 · Publisher ↗
OBJECTIVES: Considering the high prevalence of temporal bone imaging and the growing tendency to replace the CT scan with CBCT in this field, it seems necessary to determine the optimal radiation conditions in each comme...
OBJECTIVES: Considering the high prevalence of temporal bone imaging and the growing tendency to replace the CT scan with CBCT in this field, it seems necessary to determine the optimal radiation conditions in each commercial CBCT brand to obtain the best diagnostic images with minimal patient radiation. METHODS: A dry human skull was imaged by 6 radiation protocols in 4 different CBCT devices. The images of anatomical landmarks including cochlea, lamina spiralis, facial canal, semicircular canals, and modiolus, were reconstructed. Then, the quality of these images was determined by 3 observers based on a 4-point scoring system. The Kappa coefficient was adopted to evaluate the observer's agreement, and the Kruskal-Wallis and Mann-Whitney tests were used to compare the mean scores of the protocols and the superiority of the protocols in each device, respectively. RESULTS: There was no statistically significant difference between the mean scores of the protocols in the Acteon and NewTom devices. In the Kodak and Planmeca devices, the recommended protocol for imaging the temporal bone is protocol 1 and protocol 3, respectively. CONCLUSION: Considering the replacement of the CBCT device for temporal bone imaging and the variety of related protocols in these devices, to reduce the overall society dose, it seems necessary to conduct further studies to determine the optimal radiation conditions in each device. In addition, the ability to unilaterally image the temporal bone is an underappreciated advantage of the CBCT over the CT, which prescribers are not familiar with.
Progressive hearing loss in childhood - shifting from reactive to dynamic management.
Dempsey J, Kluk-De Kort K, Bruce IA … +1 more , Nichani J
Cochlear Implants Int · 2024 Nov · PMID 40152465 · Publisher ↗
Advances in worn and implantable hearing device technology is such that hearing can now be successfully (re)habilitated from mild to profound hearing loss. Whilst hearing services have access to the latest digital hearin...
Advances in worn and implantable hearing device technology is such that hearing can now be successfully (re)habilitated from mild to profound hearing loss. Whilst hearing services have access to the latest digital hearing devices, bone conduction and cochlear implants, two main research and clinical challenges remain within the pediatric population, namely (e.g. borderline cochlear implant candidacy), and Deteriorating and later-onset hearing loss are exemplars of the challenges faced.
Effects of electro-acoustic stimulation on gated word recognition.
Patro C, Shephard E, Srinivasan NK
Cochlear Implants Int · 2025 Jan · PMID 40067161 · Publisher ↗
OBJECTIVE: The objective of this study was to determine how the presentation of unprocessed speech, either ipsilaterally (to simulate electro-acoustic stimulation, EAS) or contralaterally (to simulate bimodal stimulation...
OBJECTIVE: The objective of this study was to determine how the presentation of unprocessed speech, either ipsilaterally (to simulate electro-acoustic stimulation, EAS) or contralaterally (to simulate bimodal stimulation), alongside vocoder-processed speech affects the efficiency of spoken word processing. METHOD: Gated word recognition was performed under four listening conditions: full-spectrum speech, vocoder-processed speech, electro-acoustic stimulation (EAS), and bimodal stimulation. In the EAS condition, low-frequency unprocessed speech and high-frequency vocoder-processed speech were presented to the same ear, while in the bimodal condition, full-spectrum speech was presented to one ear and vocoder-processed speech to the other. RESULTS: Listeners identified target words accurately with just over half of the word duration in the full-spectrum condition, whereas nearly the entire word was required for correct identification with vocoder-processed speech. Combining full-spectrum speech and vocoder-processed speech, whether ipsilaterally or contralaterally, led to significant improvements in gated word recognition. Full-spectrum speech yielded the best-gated word recognition performance, followed by bimodal stimulation, with intermediate results from EAS and the lowest performance from the vocoder condition. CONCLUSION: Inherent limitations in CI spectral resolution can impair spoken word processing. Adding acoustic stimulation can improve gated word recognition performance. Bimodal stimulation significantly enhances lexical processing timing compared to EAS in one ear.
Outcomes of attempted hearing preservation after cochlear implantation (HPCI): a prognostic factor (PF) systematic review of the literature.
Sladen M, Nichani J, Kluk-de Kort K … +2 more , Saeed H, Bruce IA
Cochlear Implants Int · 2025 Jan · PMID 39993422 · Publisher ↗
OBJECTIVE: There's a need to highlight prognostic factors (PFs) determining hearing preservation in cochlear implantation (HPCI), as currently there is large variability in outcomes. Given the potential benefits of HPCI,...
OBJECTIVE: There's a need to highlight prognostic factors (PFs) determining hearing preservation in cochlear implantation (HPCI), as currently there is large variability in outcomes. Given the potential benefits of HPCI, it is important to understand the factors influencing this variation. We apply a novel methodology to outline and assess the accuracy of prognostic factors reporting for HPCI. DATA SOURCES: A preferred reporting item for systematic reviews and meta-analyses compliant systematic review, searches applied to Medline, EMBASE, and Cochrane. STUDY SELECTION: The CHARMS-PF tool assessed the strength of PF study designs. DATA EXTRACTION: The QUIPS tool assessed for risk of bias. DATA SYNTHESIS AND RESULTS: Ninety-two papers were suitable for data extraction. The domain's preoperative hearing loss, size of the round window opening, round window accessibility, surgical insertion speed and route (Round window or cochleostomy), electrode length and type were identifiable exploratory PFs for HPCI. Overall, the study's heterogeneity and risk of bias precluded reporting by forest plots and meta-analysis. CONCLUSIONS: Most exploratory PF studies for HPCI are hindered by the risk of bias. This systematic review identifies potential independent PFs which should be measured, and adjusted for, in future confirmatory studies using a multivariate analysis. This would determine the independent prognostic effects associated with HPCI while facilitating prognostic model development and the predict individual HPCI.
Audiological profile in children with congenital inner ear anomalies.
Mohamed El-Badry M, Fawzy A, Makhlouf Hasan M … +1 more , Refat F
Cochlear Implants Int · 2025 Jan · PMID 39891582 · Publisher ↗
OBJECTIVES: The current study aims to describe subjects and audiological profiles of children with congenital inner ear anomalies (IEAs). MATERIALS AND METHODS: A total of 193 children with sensorineural hearing loss (SN...
OBJECTIVES: The current study aims to describe subjects and audiological profiles of children with congenital inner ear anomalies (IEAs). MATERIALS AND METHODS: A total of 193 children with sensorineural hearing loss (SNHL) and radiological evidence of one or more congenital IEAs were included. RESULTS AND DISCUSSION: The most common IEAs in the current study was enlarged vestibular aqueduct (EVA) either isolated or associated with other IEAs. Incomplete partition (IP) with its three types (IP I, IP II, and IP III) was the second common anomaly, followed by cochlear hypoplasia (CH). At the time of radiological diagnosis, hearing loss degrees ranged from mild to profound in children with EVA, CH III, and CH IV with the majority having severe or profound degrees. The prevalence of severe and profound degree of hearing loss was higher in children with IP than children with isolated EVA or CH III and CH IV. In children with isolated EVA, hearing loss was asymmetric in 52.2% and progressive in 58%. In children with CH III and CH IV, hearing loss was asymmetric but stationary. Only children with EVA and IP III had air-bone gab (ABG) at low frequencies, while children with other IEAs did not have ABG except if there was an association with EVA. Children with severe anomalies such as CH I, CH II, common cavity, and cochlear nerve hypoplasia had profound degrees of hearing loss or just sound detection. CONCLUSIONS: Knowing the audiological profile of children with IEAs has important clinical implications in the management of those children.
The effect of current amplitude and multi-electrode stimulation on eSRT for auditory fitting in cochlear implants with pulse-width loudness coding.
Molaee-Ardekani B, Goiana-Martins P, Segovia-Martinez M … +1 more , Luís L
Cochlear Implants Int · 2025 Jan · PMID 39891573 · Publisher ↗
OBJECTIVE: Neurophysiologic measures like the electrically evoked Stapedius Reflex Threshold (eSRT) offer valuable insights into personalized responses to Cochlear Implant (CI) stimuli. This study evaluates the effects o...
OBJECTIVE: Neurophysiologic measures like the electrically evoked Stapedius Reflex Threshold (eSRT) offer valuable insights into personalized responses to Cochlear Implant (CI) stimuli. This study evaluates the effects of stimulation current amplitude and the number of stimulating electrodes on eSRT and its correlation with the Most Comfortable Loudness level (MCL or C-level) in all-polar, pseudo-monophasic, pulse-width loudness coded stimulations. APPROACH: The study was conducted on seventeen adult patients with Oticon Medical implants. In these implants, current amplitude remains constant while loudness is coded through pulse-width. Stimulation amplitudes were set to low (default clinical) and high values, using single or multi electrode groups of 1, 3, and 5 (G1, G3, and G5) across five cochlear regions, spanning from apical to basal. For each amplitude and group, the eSRT detection rate and correlation with MCL were analyzed regionally and overall. RESULTS: Higher eSRT detection rates were observed in the contra-lateral ear, with G3 and G5 significantly enhancing detection over G1 for both low and high amplitudes. The current amplitude facilitated eSRT invocation, particularly for G1 and patients with higher MCLs. The correlation between eSRT and MCL was relatively high ( = 0.64-0.87) across all conditions, indicating accurate MCL estimation from eSRT at both low and high amplitudes. DISCUSSIONS: Among all condition interactions (amplitude, side, electrodes), low-amplitude contra-lateral G5 and high-amplitude contra-lateral G3 showed optimal modes for estimating MCL from eSRT, with linear slopes near 1.0, and detection rates of 54% and 63%, respectively. High-amplitude contra-lateral G5 further increased detection to 68%, though with a slope of 0.8, requiring a correction factor. These findings provide insights into eSRT mechanisms and its application in pseudo-monophasic all-polar CI programming. CONCLUSION: The eSRT detection rate can be improved in pulse-width modulation cochlear implants by using multi-electrode stimulation and/or increasing the stimulation amplitude beyond the default clinical value, without significantly affecting the correlation coefficient between eSRT and MCL.
The relationship between AutoNRT thresholds and subjective programming levels revisited.
Björsne A, Magnusson L
Cochlear Implants Int · 2025 Jan · PMID 39884962 · Publisher ↗
OBJECTIVES: The aim of this study wasto systemically examine the relationship between AutoNRT thresholds and subjective programming levels by controlling for individual subject variation, and further, to propose an alter...
OBJECTIVES: The aim of this study wasto systemically examine the relationship between AutoNRT thresholds and subjective programming levels by controlling for individual subject variation, and further, to propose an alternative way to calculate the AutoNRT threshold profile for programming purposes. METHODS: The study was a prospective observational study. AutoNRT thresholds, T- and C-levels were recorded at six and twelve months after activation. All subjects had received a CI24RE implant. RESULTS: Forty-one adults participated in the study. A linear mixed-effects model analysis of the relationship between the AutoNRT thresholds and the T-and C-levels resulted in a large unexplainable variation between subjects, the standard deviation was between 15.42 and 18.89 CL. However, the study showed that the profiles for the T- and C-levels could be predicted with an acceptable accuracy from AutoNRT. A model for calculating profiles from AutoNRT thresholds based on linear regression resulted in the lowest deviation from the subjective programming thresholds, with somewhat better results for C-levels than T-levels. CONCLUSION: The results from this study showed that the predictability was reasonable when calculating the profiles for the T- and C-levels based on AutoNRT. And, further, that AutoNRT thresholds can be used when programming cochlear implants, to make global adjustments without predicting actual T- or C-levels.
Translation and validation of the Hearing Environments and Reflection on Quality of Life (HEAR-QL) questionnaire for preschool children in Dutch.
Batthyany C, van der Schroeff M, Vroegop J
Cochlear Implants Int · 2024 Nov · PMID 39879376 · Publisher ↗
OBJECTIVE: Early diagnosis, intervention and consistent follow-up of hearing loss is of great importance in children, given the broad impact of untreated childhood hearing loss. Currently, no hearing-specific QOL proxy q...
OBJECTIVE: Early diagnosis, intervention and consistent follow-up of hearing loss is of great importance in children, given the broad impact of untreated childhood hearing loss. Currently, no hearing-specific QOL proxy questionnaire exists for preschool children with hearing loss in the Dutch language. Therefore, the aim of this study was to translate and validate the Preschool HEAR-QL questionnaire into Dutch. METHODS: Translation was conducted according the forward-backward procedure. Parents or caregivers of 60 normal-hearing children and 50 children with bilateral hearing loss aged 2-6 years old were invited to digitally complete the questionnaire. RESULTS: The Preschool HEAR-QL questionnaire showed good discriminant validity between the normal-hearing and the hearing loss group, for its total score and some subscales. We concluded satisfying internal consistency given Cronbach's alpha values being above 0.70, nearly all alpha if item deleted values approaching the overall values, and item-subscale correlations above 0.30. Test-retest reliability was satisfying with all intraclass correlation coefficients being greater than 0.70. CONCLUSION: This Dutch hearing-specific QOL proxy questionnaire can play an important role in the management and follow-up of early childhood hearing loss in Dutch health care and hearing centers. Future research on clinical data will further verify its utility in clinical practice.
Cochlear reimplantation rate, causes, and outcomes: a multicenter study.
Asghari A, Farhadi M, Daneshi A … +13 more , Hashemi SB, Mirsalehi M, Saki N, Rajati M, Abtahi S, Emamdjomeh H, Karimi M, Bayat A, Dehghanpour Y, Monshizadeh L, Sepehrnejad M, Mirza Torabi SS, Omidvari A
Cochlear Implants Int · 2024 Nov · PMID 39773095 · Publisher ↗
OBJECTIVE: The current study aimed to evaluate cochlear reimplantation rate, causes, and audiological outcomes in a large group of patients in a multicenter study. METHODS: This retrospective study was conducted on patie...
OBJECTIVE: The current study aimed to evaluate cochlear reimplantation rate, causes, and audiological outcomes in a large group of patients in a multicenter study. METHODS: This retrospective study was conducted on patients with cochlear reimplantation surgeries between 2000 and 2022 in five academic referral centers. The rate and reasons for cochlear reimplantation surgeries were evaluated. The auditory performance and speech production outcomes were compared before and after cochlear reimplantation surgeries. RESULTS: Of 9,287 primary cochlear implantation surgeries, 186 reimplantations were performed (a cochlear reimplantation rate of 2%). The highest risk of reimplantation was found 2 to 4 years after primary implantation. Device failure was the main reason for cochlear reimplantation (81.2%). The categories of auditory performance and speech intelligibility rating scores were unchanged or improved in 57 out of 59 patients (96.6%), and 55 out of 59 patients (93.2%), respectively. CONCLUSION: The cochlear reimplantation rate seems to be relatively low, with the cause of device failure in most cases. While the highest risk of reimplantation happened during the first four years after primary surgery, regular follow-ups are necessary, particularly during this time. The audiological outcomes do not worsen after reimplantation in most patients, and some children may experience some improvements.
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